2024 IMPACT REPO RT
CHILDHOOD IS PRECIOUS
Whenever, wherever we’re needed, now and in the future
While life is very different, children with life-limiting conditions and their families still need the same things all children and families need. At Julia’s House, we help the children we look after enjoy being children, while their families know they are living life to its fullest potential. In hospice care, every moment carries meaning and memories always matter. We help the children we look after enjoy just being children, while their families know they are having the very best care, love and attention.
Julia’s House delivers compassionate, tailored children’s palliative care that addresses the physical, emotional, and developmental needs of children, while supporting families during challenging times. Through collaboration, innovation and an unwavering focus on quality, we make a lasting impact on the children and families in our care.
“When I first came to the hospice I didn’t know what to expect, the kids are so poorly, but they’re all so happy. This is their sanctuary. Julia’s House really goes above and beyond for the whole family, giving us help and support emotionally and physically.”
Rachel, mum to Drae
206 children and their families received support from Julia’s House
Recent NHS data shows the increasing number of children in Dorset and Wiltshire with lifeshortening conditions that will require support in their local community. Support that Julia’s House provides.
[source: NHS hospital admission data, December 2023].
Our Outstanding care fills gaps in statutory services - 24/7 end of life care is not available through the NHS at home in Wiltshire and only partly available in Dorset.
[source: Freedom of Information requests].
And as our clinical and medical expertise and reputation grows, so do referrals, with a 41% increase in 2024. We provided 15% more care in 2024 than in 2023 and our end of life and post-death hours have increased by 146% over the same period and will continue to form an even bigger part of our services.
Ensuring a sustainable future
Despite income growth in both fundraising and retail, 2023/24 was by a distance the worst financial year we have ever seen for the hospice sector, driven by rising costs. With government contributions declining in real terms, around two thirds of hospices recorded a deficit .
[source: Hospice UK].
Over two years, hospices will have seen their wage bill rise by one fifth and at Julia’s House, our costs have risen by around 25% in total in the last three years. In contrast, we received just under 8 per cent of our 2024 income from the Government.
In 2024 Julia’s House played a significant role in bringing the financial needs of hospices to the Government’s attention, generating meetings at the Department of Health & Social Care and achieving major television and press coverage. This reinforced the work undertaken by Hospice UK and Together for Short Lives. At the end of 2024, the Government announced a significant fund for hospice capital costs that will run until March 2026.
Because of the time-limited nature of the national fund for hospice capital costs, and the mixed picture in funding from one county to the next, it remains vital to secure long-term stability for hospice financing nationwide. We will continue to campaign for sustainable funding for children’s hospices across England.
A safe space for families
We recognise the needs of a child with a life-limiting condition and their family go far beyond the physical. When you become your child’s carer, there are no breaks unless you have support and you need that support close by. We create a space where families feel held, listened to, safe and supported. We help the whole family make the most of their lives together.
Time for us
James needs constant care - day and night - for his complex condition. The 15-year-old can only communicate by eye gaze and sounds. He also has epilepsy and has previously suffered from seizures, which is kept under control with medication.
“We were so grateful to Julia’s House for offering to look after James at the hospice overnight, so we could have one night on our own together. And we could relax because we knew James was in safe hands, having the most amazing care.
“Julia’s House gave me the chance to be a husband, and not a carer for the night. The care that they provide is above and beyond a fun afternoon for James; they help us all, however and whenever we need their support.”
Nigel, dad to James
“James had been in hospital that week vomiting, and we thought that we’d have to cancel but the Julia’s House team said if he was well enough to come out of hospital, they would still take him. I hadn’t washed or shaved because I’d been in hospital, so I looked a state by the time we got to the restaurant, but I’m so glad we decided to go ahead with it. We only went for a meal and a night in a local pub, but it was so important to have that time for us.”
“Julia’s House is so important. While Isla’s with her Julia’s House nurses and carers, I can be me for a couple of hours. It kind of re-sets you.“
Georgia, mum to Isla and Darcy
Reset and restart
When Isla was born very prematurely at just 24 weeks she was so tiny, she fitted into the palm of her Dad’s hand. She weighed just 517 grams and was 28cm long – smaller than a ruler.
“Caring for Isla is relentless. You can’t leave her at any point, you’ve always got to have your eyes on her because she can be a pickle and pull on her oxygen tube or suddenly get really poorly.
“She is constantly attached to oxygen, so we have to carry her oxygen tank everywhere we go and check her levels and heart rate regularly.
“She’s also connected to her feed pump for her main nutrition since her big cardiac arrest as her stomach shut down.
“Life with Isla can be exhausting – it’s physically and emotionally hard. You can have a plan of what you want to do, but Isla ultimately decides. She’s the boss.”
39
new children and their families were welcomed to Julia’s House for care
42% 58%
42 per cent of care took place in the community; 58 per cent in the hospices
9
children moved from Julia’s House care into adult care
Helping families be families
“It’s hard to feel normal when you have a little one with complex care needs. I can’t just pop out to a soft play because Sully could catch an infection or virus, and I’d need to take seven bags packed with his back-up meds and milk. But when Julia’s House comes, I can just do simple things that make me feel normal.
“Julia’s House helps us in so many unexpected ways – they don’t just look after Sully, they look after all of us. The support they have given to me and Jake, and to our four-year-old son Reuben is just incredible.”
Our care provides parents with the clinical security that our nurses and carers understand the complex needs of their child and will know exactly what to do if there is an emergency. But it is also essential that we support their emotional health and wellbeing so each family member can maintain a healthy balance and cope with each difficult day.
Our Family Support Services (FSS) surround the whole family because the impact of caring 24/7 for a seriously ill child affects everyone. Each area has to be responsive, and we work together to provide the family with what they need in that moment in time. It’s like a hug around the whole family. This vital service encompasses therapies such as counselling and play, art and music and sibling support, while our social work advocates and supports families with safeguarding, financial support, general guidance, and signposting to other professionals. We can’t change all the tough times – but we can be there to listen to parents and acknowledge what they’re going through.
23,532
hours of care given to families in 2024
Complementary therapy
“I’ve had the most amazing massages from the Complementary Therapy team and I’m hoping to have free counselling through the family support team too. Some days are great and positive, but some days I don’t know how I’ll make it through the next hour –talking really helps me and I don’t want to put all my worries on Jake, so to have that support is vital for me.“
Massage can help with symptom management and pain relief for a child, helping to soothe and settle them. It relieves sore muscles for a parent who has to carry and lift their child and can also aid relaxation and sleep – something many parents struggle with. Our complementary therapists provide a wide range of treatments to ease stress and help family members relax and unwind. It’s both a treat and a treatment, benefitting the individual’s physical, psychological and emotional needs, whether in the hospices or at home. Complementary therapy is also used to ease children’s day-to-day symptoms and in end of life care.
Lucy and Jake, parents to Sully and Reuben
Cost of living impact
The cost of living disproportionately affects parents of disabled children: one or both parents may have to reduce their hours or give up work to care for their child, and that child requires more heating to keep warm or electricity for their wheelchair. Our family support workers research and apply to sources of grants for these families:
“There’s even a Family Support team at Julia’s House that helps with applying for funding and anything else you might need. For example, we recently received a £300 grant for sensory equipment that will make the world of difference for Sully at home. And the lovely Family Support Worker, Emma, is trying to help us find a car seat that will be so much better for Sully than anything we could buy on the high street. Completing a task like that feels impossible when all your time is taken up caring for your seriously ill child. “
Lucy, mum to Sully
We secured over 140 grants totalling £135,500 for families to help pay for specialist equipment, finance and housing needs
Sully with mum Lucy
Sibling support
Having a brother or a sister with a lifelimiting condition means siblings have to witness and deal with a lot of things other children never have to face. It is easy for them to get worried or frightened and to feel isolated.
Each sibling has their own dedicated sibling worker who adapts to each brother or sister’s unique situation. They can spend time with them on a one-to-one basis, nurturing emotional needs, helping them to share fears and concerns, or at fun activities and social events that enable peer support and friendships. And our overnight activities allow a complete break from being young carers.
“The impact of our way of life on William’s sisters is huge too. They have their own worries they don’t necessarily want to share with us when they’re putting a brave face on. That’s where Julia’s House has been brilliant too. Their sibling support team have given our girls a chance to meet other children experiencing a similar normality. And it’s not even about deep sharing, it’s about having as much fun as possible, with other siblings who are living a similar day-to-day.
“Support. That’s the biggest thing Julia’s House gives us all.”
Will, William’s dad siblings benefitted from our sibling service
William with his sisters, Nicola, Lucy and Joanna
Key Achievements in 2024:
Continue to provide dynamic, responsive, innovative and essential care to every eligible child and support for their family.
• 39 new children & their families welcomed
• 206 babies, children and young people and their families received support from JH (140 Dorset, 66 Wiltshire)
• 58% Hospice / 42% Community care overall
• 23,532 hours of care given (incl. respite, family support and end of life)
• 182 hours of counselling support provided
• Secured 140 grants for families totalling £135,500
Measure the impact of care, demonstrating the effectiveness of our holistic approach and elevating the value of comprehensive clinical and holistic support to the whole family.
• Recruited a data analyst to aid evidencing care impact and key learnings
• The Care team achieved a major milestone with the successful rollout of SystmOne, our new electronic children’s record system. This project, launched in November after nearly two years of work, was made possible by the dedication of Care, Care Admin, IT and NHS partners
Continue to collaborate with our partners to provide sustainable, equitable and excellent palliative care across two counties.
• Eight children received end of life (EOL) care including post death
• Continued collaboration between Poole Hospital and Julia’s House enabled EOL care at home with 24/7 support delivered through joint rotas, enabling family choice
• Two weeks hospice-based EOL care provided through collaboraton across University Hospital Southampton, Poole Hospital and Julia’s House
• EOL care provided at home in Wiltshire with the provision of 24/7 care to ensure the family were supported in their place of choice
Retain and recruit a highly skilled, passionate and engaged workforce.
• In 2024 Julia’s House ranked 10th in Best Companies’ Top Charities To Work For, a nationwide comparative staff survey, and achieved their ‘Outstanding’ employer standard
• One Nurse Associate and One Team Nurse appointed, five new recruits to Family Support Services roles
• 16.5% attrition of care staff (14 leavers of 85 care staff)
• 4,140 hours of care staff training delivered
• Introduced clinical supervision to support the wellbeing of clinical staff
• Ongoing commitment to the training and supervision of first Julia’s House Trainee Advanced Nurse Practitioner
• Successful completion of return to nursing practice course with retention of qualified member of nursing team
Closely monitor and report on performance of income and expenditure versus budgeted levels.
• Quarterly financial dashboard with detailed analysis of income, investments and expenditure reviewed by Board of Trustees
• Reviewed investment portfolio and risk profile to help guard against market volatility
• Commissioned analysis of likely future legacy income based on demographic trends
• Legacies were below budgeted levels but still accounted for 41% of the charity’s voluntary income in 2024
Seek stronger partnerships with local Health & Social Care Integrated Care Boards to improve children’s palliative care.
• Nine young people transitioned into adult care (four Dorset, five Wiltshire )
Continue to invest in voluntary income generation and public awareness.
• The Great Tail Trail art trail was launched in Dorset to generate additional voluntary income, attract new supporters and re-engage lapsed supporters as well as generate significant public awareness (The Great Tail Trail 5 April-1 June 2025)
• Appeals generated £110k income in total including Gift Aid; Christmas Appeal received additional PR and marketing support to maximise impact
• Permanent Julia’s House mural created at high traffic Swindon Designer Outlet
• A Wiltshire-focused PR & marketing campaign doubled broadcast coverage in the county, generating 36 items of TV coverage across the year
Open more shops across both Dorset and Wiltshire.
• Swindon shop opened and has generated a profit of just over £79k in 2024
Consistently promote the importance of legacy giving to supporters.
• New legacy marketing campaign developed with insight-driven creative
• 557 hours of end of life care given to children and their families
• Initially promising negotiations were held to try to increase the level of contribution from Dorset NHS commissioners from 2025 onwards but they subsequently declined to increase our income in real terms
• Julia’s House will not receive any regular ongoing commissioning income from Wiltshire NHS commissioners for the foreseeable future. Instead, they have contracted a private sector company to provide services, which will be under no obligation to commission hospices
Continue to influence local and national policy makers to seek more sustainable funding for hospices.
• Ongoing Government lobbying campaign, working with Hospice UK and Together for Short Lives generated widespread TV and broadcast media coverage and hospice visits from local MPs in Wiltshire and Dorset
• Meetings held with the Department of Health and Social Care
• Facebook parent-led campaign group established
• One off hospice Government capital grant provided for 2024 and 2025
Drae with nurse Amy Foster
Finance and governance
The Care Quality Commission rates both Julia’s House services, for Wiltshire and Dorset, as ‘Outstanding’.
All the services Julia’s House provides are completely free of charge for our service users.
Although a number of sources of income grew in 2024, costs rose faster and Julia’s House posted a deficit in the year and the charity had to rely on its reserves.
The hospices capital fund recently created by the Government is very welcome, although it will end in March 2026. As it is a capital fund, it will be unable to help support our biggest expenditure – staff salary costs. Additionally, staff costs will be increasing by approximately £250,000 per year due to the Government increase in employer National Insurance contributions.
With a long-term solution to Government funding of hospices still elusive, and continuing deficits forecast, Julia’s House faces difficult choices going forwards.
Financial deficits are expected for at least the next three years due to the economic climate.
To address the deficit and work towards a balanced budget, a new four- year strategic plan and priorities was launched focusing on maintaining outstanding care levels, optimising operations and reducing expenditure, including the establishment of a cost saving action group to actively identify opportunities for savings across the organisation. The plan also reflects a more focussed approach to identifying and maximising priority income streams and targeted improvements in systems and processes to drive efficiencies.
Income £10,220,664
∞ Shops
£3,213,426
∞ Investments
£189,724
∞ Donations & Legacies
£4,862,427
∞ Statutory funding
£782,608
∞ Fundraising events and lottery
£1,172,479
Note: Julia’s House posted a deficit of £145,763 in the year, after accounting for a gain on
Reserves
It is the charity’s policy to hold between six- and twelve-months’ worth of operating expenditure in reserves that are accessible. The critical importance of having such reserves is clear from the current economic climate.
The charity’s reserves at the end of 2024 constituted 12.6 months’ worth of 2025 budgeted operating expenditure. This is forecast to reduce over the next three years with further budgeted deficits. The Trustees therefore assess that the current level of reserves is prudent and necessary to maintain the charity’s care services.
£10,900,883
∞ Shops
£2,617,106
∞ Raising funds
£1,878,287
∞ Delivering care
£6,405,490
77% of expenditure (excluding retail) was spent on delivering our care
Breakdown of donations income £4,862,427
investments of £534,456
The charity is profoundly grateful to everyone who remembers Julia’s House in their Will. Legacies were below budgeted levels but still accounted for 41% of the charity’s voluntary income in 2024. Expenditure
∞ Gift Aid - £404,218
∞ Major donors - £486,045
∞ Legacies - £2,472,606
∞ Gifts in kind - £1,200
∞ In memorium - £94,939
∞ Corporate support - £365,501
∞ Individual donations - £300,114
∞ Community fundraising - £450,252
∞ Trust & foundation grants - £255,477
∞ Miscellaneous income - £32,075
Our people, Equality, Diversity and Inclusion
Everything we do in caring for the children of Julia’s House is about treating them equally, as individuals, and seeing their potential rather than their limitations: maximizing their opportunity to play, live, love and thrive within the family and the wider world.
In our most recent anonymous survey of service user families, 100% of respondents said the service met their family’s needs in terms of race, culture, ethnicity and diversity.
We strive for a similarly fair, diverse and inclusive working culture that supports people to excel. We offer flexible working wherever possible, advertise many vacancies nationally, highlight underrepresented groups in our workforce and encourage applicants from these groups, operate ‘blind’ shortlisting good practice, and train managers in fair recruitment practices.
A full statement on our actions around Equality, Diversity and Inclusion can be found on the charity’s website.
Volunteers
Julia’s House has 608 registered volunteers. They make a huge contribution to the charity’s services, fundraising and cost-effectiveness, as well as raising awareness of Julia’s House in their communities.
Overall volunteer support in 2024 remained in line with the high levels that we saw in 2023. In 2024 volunteers gave almost 73,000 hours of support, the equivalent of 40 full time staff and a cost saving to the charity of £850,000 (if based on National Minimum Wage). Additionally, many of these roles generate substantial income in retail and fundraising. Many other volunteer roles are in care support. The charity is extremely grateful for all this vital help.
The charity’s Board of Trustees and the Directors of its Trading Company are all unpaid volunteers.
Our Planet
During 2024, we sold 778,605 items across all our shops.
We sent and received payment for the following weights of items to recycling companies:
• 146,061kg of textiles + 30,989kg of linens and curtains
• 31,208kg of shoes, handbags, belts and hats
• 64,098kg of bric a brac items
• 110,586kg of books
Our environmental working group monitors environmental practice across the organisation and identifies opportunities to improve.
We are members of the Woodland Trust carbon scheme.
Julia’s House Strategy 2025-2028
Adapting to today’s circumstances, ensuring care for tomorrow’s children
Priority 1
Provide & maintain excellent care
We will modernise our ways of working to maximise productivity and efficiency. Our strategic priorities
We will continue to offer the absolute best care to children and their families, prioritising those requiring end of life care in their place of choice, at home or in the hospice.
Priority 2
Ensure a financially sustainable organisation & services
Priority 3
Optimise our culture to maximize our impact
Priority 4
Prioritise income streams with biggest potential
Priority 5
Support our goals through better processes & systems
We will close the gap between our income and expenditure to protect the charity over the long term, balancing our budget by end of 2028.
We will tap into the full potential of our staff and volunteers through greater collaboration, skill sharing and information flow.
We will invest in areas of income with the greatest opportunity for growth.
Find out more about the children and families we support
