Facts and figures

What we do

Acorns provides babies, children and young people aged 0-18 years who have life limiting or life threatening conditions and associated complex needs with a network of specialist palliative nursing care and support.

Eligibility for children is based on the four categories of life limiting or life threatening conditions as established by Together for Short Lives:

  • Conditions where curative treatment may fail
  • Conditions where premature death is inevitable
  • Progressive conditions without curative options
  • Irreversible conditions causing severe disability

For full details see endnote [i]

Please do not use the phrase ‘terminally ill’. ‘Not expected to reach adulthood’ is preferred.

A holistic service meets the needs of both the children and young people and their families, including the bereaved. This includes short break provision, emergency and end of life care, therapeutic and psychosocial support, sibling services and family support.

Acorns serves the areas of Birmingham, Coventry and Warwickshire, Walsall, Sandwell, Dudley, Wolverhampton, Worcestershire, Herefordshire, Gloucestershire, Staffordshire and Shropshire.

The children and families we support

In the past year[ii], Acorns supported 704 children and 940 families across the organisation, including those who have been bereaved. Acorns are currently supporting:

  • Around 263 children and their families at Acorns in Birmingham[iii]
  • Almost 216 children and their families at Acorns in the Black Country[iv]
  • Around 225 children and their families at Acorns for the Three Counties[v]

On average, every month, five of the children Acorns cares for will die.[vi]

43% of the children and families at Acorns are from BAME (Black, Asian and Minority Ethnic) backgrounds.

Approx. 3% of the children Acorns cares for have cancer.

Our facilities and services

Working with the family, Acorns undertakes a full holistic assessment, from which we are able to determine the outcomes the family needs to achieve for them and their child. Support is then delivered in response to the family’s requirements. A package of care is tailored for each individual child which includes all their medical, emotional, cultural, religious and spiritual needs. This package can be provided in the hospice, a family’s home or elsewhere in the community.

The hospices

Acorns has three children’s hospices:

  • Acorns in Birmingham (located in Selly Oak) opened in 1988 (the third children’s hospice in the world at the time)
  • Acorns in the Black Country (located in Walsall) opened in 2000
  • Acorns for the Three Counties (located in Worcester) opened in 2005

The hospices are purpose built with 10 specially decorated bedrooms designed to cater for children and young people from birth to 18 years of age. They are designed to be a homely environment to help children enjoy their stay and make the most of every day.

On-site hospice facilities include hydrotherapy pools and spas, multi-sensory rooms, complementary therapies, play and activity areas with up-to-date IT equipment and landscaped gardens.

Special adolescent areas ensure privacy and a managed level of independence for older children.

Separate on-site accommodation for families allows them to stay with their child if they wish.

The hospices have ‘special bedrooms’ in a separate area within the building where children can stay after they have died until their funeral.

Acorns services

On acceptance to Acorns every family will receive an assessment of their needs. This will be undertaken by a professional who has a health or social care background. They will work with the family to determine the services that will best meet their needs at the current time and agree a plan of care and support that may include: psychosocial support, advocacy, short breaks in the hospice or at home, sibling support and a range of support groups for all members of the family. End of life care and bereavement support will be available whenever is it needed and all families will have access to emergency support via the hospices 24 hours a day.

Each hospice has a team comprising:

  • Registered Children’s Nurses
  • Health Care Assistants (HCAs)
  • Physiotherapists
  • GP (supported by the Acorns Paediatric Consultant)
  • Family Team Workers
  • Volunteer Managers
  • Sibling Workers
  • Administrative, housekeeping and kitchen team
  • Trained volunteers

Care is provided during a hospice stay (whether this is a planned short break, emergency or end of life care) including:

  • Personal care
  • Medical support
  • Symptom management
  • Pain control
  • Physiotherapy including hydrotherapy
  • Complementary therapies
  • Play and activities including creative sessions/workshops such as art and craft, music, drama, puppet shows and dance
  • Access to IT equipment, toys, books, CDs and DVDs

An Outreach Team of nurses and volunteers is also able to offer support to families within their home.

Sibling Workers provide support to around 200 siblings through focused groups, individual therapeutic based sessions and bespoke programmes, according to assessed need.

Acorns runs a programme of specialist support groups for:

  • Grandparents
  • Bereaved parents
  • Parents and carers
  • Siblings
  • Dads/men
  • Mums

These support groups bring together those in similar situations, reducing isolation and helping develop resilience, self-esteem and a sense of identity.

Governance, regulation and representation

Acorns is an independent charity managed by an appointed Chief Executive and a senior management team who are accountable to a board of trustees.

A number of formal groups including parents, carers and young people provide regular feedback and input into how services are delivered and can be improved to better meet needs.

These include:

  • Young Ambassadors
  • Parent Carer Champions
  • Siblings Council

Care services are regulated and audited by the Care Quality Commission (CQC): www.cqc.org.uk

Acorns is registered with the Fundraising Regulator (FR) – the regulator for fundraising in the UK: www.fundraisingregulator.org.uk

Acorns is a member of Together for Short Lives– The UK voice for children and young people who are not expected to reach adulthood and their families: www.togetherforshortlives.org.uk

Acorns is a member of Hospice UK – the national charity for hospice care: www.hospiceuk.org


It costs around £10 million a year to run our care services in the hospices and community, providing care for the child and support for families.

It costs around £27,000 per day to run Acorns care services.[vii]

It costs around £7,000 a day to run care services within one hospice.[viii]

It costs around £975 to provide a nurse-led 24 hour palliative care break for a child in a hospice.

Acorns relies heavily on the community to fund the majority of our activities. In the past year [iv], the local community provided 60% or £6 million of the money needed to run our care.

Income from Clinical Commissioning Groups (CCGs) and other statutory bodies represents a contribution of around 35% towards the total cost of our care services.

Our last set of audited accounts[x] show:

  • 86p in every £1 we spent went on charitable activities (i.e. care services);
  • we raised £4.14 of income for every £1 we spend on non-charitable activities (i.e. fundraising); and,
  • we generated approximately £1.1 million net profit by selling mainly donated goods in our network of over 40 shops across our region.

Acorns participate in two lotteries: TLC in Birmingham tlclottery.co.uk and the Hospices Lottery in Worcestershire.

Acorns runs its own lottery – the Acorns Weekly Lottery www.lottery.acorns.org.uk.

Acorns is part of Childlife, a fundraising partnership between four charities working with children, young people and their families throughout the UK: www.childlife.org.uk.

Our people

Acorns employs around 360 staff in its three hospices, network of shops and head office[xi].

Acorns has over 1,300 active volunteers[xii] who work in all areas of the organisation[xiii]:

  • Around 300 in the hospices (100+ in the Black Country, 100+ in the Three Counties, 100+ in Birmingham)
  • Over 200 in fundraising and events
  • Around 900 in our retail shops 

Figures last updated September 2020

[i] Eligibility criteria (as outlined by Together for Short Lives)

Category 1

Life threatening conditions for which curative treatment may be feasible but can fail. Access to palliative care services may be necessary when treatment fails or during an acute crisis, irrespective of the duration of threat to life. On reaching long-term remission or following successful curative treatment there is no longer a need for palliative care services.

Examples: Cancer, irreversible organ failures of heart, liver, kidney.

Category 2

Conditions where premature death is inevitable. There may be long periods of intensive treatment aimed at prolonging life and allowing participation in normal activities.

Examples: Cystic fibrosis, Duchenne muscular dystrophy

Category 3

Progressive conditions without curative treatment options. Treatment is exclusively palliative and may commonly extend over many years.

Examples: Batten disease, mucopolysaccharidoses

Category 4

Irreversible but non-progressive conditions causing severe disability, leading to susceptibility to health complications and likelihood of premature death.

Examples: Severe cerebral palsy, multiple disabilities, such as following brain or spinal cord injury, complex health care needs, high risk of an unpredictable life-threatening event of episode. 

[ii] From 1 April 2019 to 31 March 2020

[iii] As of 31 March 2020

[iv] As of 31 March 2020

[v] As of 31 March 2020

[vi] In the year to 31 March 2019, 63 children passed away

[vii] It costs around £9,090 per day, per hospice to run both in-house and community services. £27,000 per day is the total for the three hospices as a whole.

[viii] It costs on average £6,820 per day, per hospice to run Acorns in-house care and support services. 

[ix] In the year to 31 March

[x] Financial figures are based on 2019/20 accounts as reported – available online at www.acorns.org.uk/publications

[xi] As of 31 March 2020

[xii] As of 31 March 2020

[xiii] Volunteers may cross over different areas of the organisation