The council's health cabinet member says the council "doesn't have enough money" for plans to roll out an "excellent" health and social care system.

At a recent health overview and adult social care scrutiny committee meeting, councillors and officers discussed plans to support palliative care in the borough. 

Palliative care involves caring for the terminally ill and their families, and is carried out in the borough by organisations such as Bolton Hospice, St Ann's Hospice and by the NHS. 

Speaking at the scrutiny committee, an officer said: “The vision in Bolton is around ensuring that all people within Bolton approaching end of life receive well-coordinated, high-quality care and support the alignment with their wishes and preferences.

“The demand for palliative care needs will increase. Our population is projected to increase, our over-80s are projected to increase as well.

“If you take that as a predictor of the number of people that would be on a GP practice list at end of life, which is about one per cent, we are looking at 3,000-3,500 people at any one time within that cohort." 

She added: “It is also about taking system review to support the system-wide provision of palliative care, but also to ensure that we have got stability within our hospice sector.

“How hospices are funded is very different to the rest of the NHS, and there is a bit of vulnerability across the whole hospice sector at the minute.

“Our main priority, despite all of those challenges that we’ve talked about, is to try to find a way that we can help and have that support and stability around a hospice." 

Chief executive of Bolton Hospice, Leigh Vallance, spoke at the meeting.

She said: “I can just briefly outline the funding structure of a hospice, which, since the outset, has always been that the majority of the income comes from fundraised income from the local community.

“That is matched by an NHS contribution, so for example, £2 worth of income generated by the people of Bolton would be matched by £1 worth of NHS funding.

“However, since austerity, that has dropped to 90p, to 80p, to less than 70p, while the costs have increased and the complexity of the care that we provide has increased, and the compliance demands have increased.

“A big hole has opened up, and that is a challenge for the system, as well as for the hospice, as well as for the people of Bolton.”

The officer added: “We are working together to think about where the need for the beds is, where is the need for that care, and we have all our partners signed up, which is quite unique across GM, to be able to say we will shift funding where it is needed.

“But we need to find ways of being able to reduce demand so we are not leaving one partner with a funding problem.” 

Cllr Linda Thomas, the council's portfolio holder for adults, health and wellbeing, said: “The system we are trying to bring in… is really excellent, and there is a real willingness to get everything that you see in here.

“But I have to say it, and they’re officers so they can’t say it, at the end of the line, we haven’t got enough money to deliver what we want to.

“When you are trying to integrate, you have still got to keep other systems going, and it is how you keep two systems going on one lot of money.

“It is just recognising that adult social care and the NHS need more money, and if we can get some more money in the system, we can then develop a great integration.”

Chair of the meeting, Cllr Gary Veevers, added: “Yes, and we have been promised time and time again that we will get a review of adult social care, haven’t we.

“But we are still waiting.”

Earlier this year, The Bolton News launched our "Save Bolton Hospice" campaign, pledging to raise £100,000 after it was revealed in June that the site is running at a £1.2 million loss and could be forced to cut nearly a third of its beds.