The hospice, which offers palliative care and support to patients and their families in North Hertfordshire and Stevenage, revealed a significant funding shortfall in September.
Now, a formal 30-day consultation on services has been announced.
Lisa Hunt, the charity’s CEO, said: “A few weeks ago, we asked our community to stand with us once more as we faced a significant £750,000 funding gap this year – rising to £1.1 million next year.
“To date, we have received £134,075 in donations from those who heard our call. We are deeply grateful for your generosity and the belief you continue to show in us.
“Sadly, despite this incredible support, it isn’t enough. Today, we face the most serious challenge in our hospice’s history.”
The charity receives 29% of its total funding from the NHS for core hospice and health services that it commissions and funds on behalf of patients, leaving the hospice to raise the other 71% through donations.
Ms Hunt said that there has been a decline in giving across the charity sector, and Garden House Hospice Care has been affected by this.
She said: “This leaves [us] with some difficult decisions to take now, to ensure that we will still be here to support our community this year and in the years to come.
“We now have no choice but to act, so implementing a plan we never wanted to use is our only way of sustaining Garden House for the future.
“We are confident that taking immediate action will enable us to protect hospice care for our current and future patients and their families.
“It is with great sadness, we are entering a formal 30-day consultation on services, which we expect could result in over 20 redundancies.
“Our focus is on supporting patients, family members and colleagues through this uncertain time whilst we face our new reality.”
Garden House Hospice Care’s full range of services will remain unchanged throughout the consultation period, Ms Hunt confirmed.
She continued: “In the future, services may look different, structures may change, but one thing is for certain – our commitment to quality and compassionate care in the final phase and days of life for our patients, their families and carers remains our biggest priority.”
Ms Hunt said that “the silence from national decision-makers is deafening”, and that hospices across the UK have been warning of this crisis for years.
She pointed to two-thirds of hospices facing a funding shortfall last year, and 40% of hospices this year being forced to cut services.
She warned that “this is expected to rise”, adding: “This is not just a funding crisis – it is a care crisis.”
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Ms Hunt said: “We vow to continue to put our patients first and to support them through any changes to their care.
“We are and will continue to do everything we can to minimise the impact on them and their loved ones.
“The care we provide is irreplaceable. Our holistic model encompassing specialist medical, nursing, physiotherapy, occupational therapy, psychological and spiritual care makes us uniquely placed to deliver high-quality end of life care both in the hospice and out in the community.
“Every member of our team plays a vital role in supporting patients and their loved ones at the most difficult time in their lives.
“To secure that care for the future, we must urgently review every service we provide. Services that have an impact on both physical and mental wellbeing – services about prevention, about supporting people to live their best lives with adequate care wrapped around them.
“We have and always will go the extra mile for our patients and community and have bridged a real gap in services in our locality.
“Unfortunately, we don’t have the funds to continue our current level of provision. If we don’t take drastic action now, we could completely threaten our whole hospice.
“Our consultation is now underway. We must remove £1.1 million from non-NHS commissioned services before April 2026.”