On the surface there's much for hospices to be optimistic about: an end-of-life strategy due from the government, increasing talk about the importance of the voluntary sector, a growing awareness of current limitations in commissioning and a widespread recognition that excellent end-of-life care is for all.

However, there is much to be done. Despite the choice agenda there is a lack of engagement with providers who have been providing choice long before it was politically fashionable.

In our fringe events with the RoyalCollege of Midwives, we will be reminding audiences that most hospices are charities providing innovative, expert care, free of charge to patients in their homes, day centres and inpatient units.

We want to explore the difference between tick-box choice and real choice. This is about tailored care; about how patients wish to live until the end of their lives; about responding to changing needs.

It also involves spreading the hospice experience and knowledge beyond the organisation itself. Hospices are training primary care practitioners, care home staff and district nurses in end-of-life care and are increasingly involved in co-ordinating palliative care for their region.

Yet for all the talk of engaging with the voluntary sector and the promises of full cost recovery and stronger commissioning, adult hospices in England are still receiving just over a third of their costs from state sources. Recent research by Help the Hospices shows that increasing numbers are under pressure: over 25 per cent of English adult hospices recorded a deficit in 2005.

Hospices do not want to be funded 100 per cent by the state. They recognise the benefit of charitable funding and the freedom to go beyond NHS formulas in the choices they offer. But they must receive statutory funding for essential NHS services to free up charitable funding for other services. This needs political pressure on commissioners to engage and understand the voluntary sector.

As we approach World Hospice and Palliative Care Day on 7 October, we need policy makers to leave these conferences determined to ensure access to the best care possible. For many families that will mean care provided at least in part by hospices.

David Praill is chief executive of Help the Hospices