Accept We recognise that access to high-quality palliative care and end-of-life care for BCYP, and those transitioning between children’s and adult services is variable. The MSF will provide an all age, clinically-led, evidence-based framework to support sustained improvement in patient and carer outcomes, including narrowing inequality and reducing unwarranted variation. Areas of action have been identified for those commissioning and delivering services with associated performance and outcome metrics to support system accountability, including specific metrics under development that are relevant to BCYP. NHS England and DHSC are working closely with stakeholders with expertise and experience in palliative care and end-of- life-care for BCYP in the development of the MSF. The best mechanisms for providing BCYP and transition-specific standards are the statutory guidance and service specifications, which we will be refreshing later this year. The revised statutory guidance and service specifications will be designed to further support ICBs to commission using a system-wide approach across primary and community care, the voluntary sector, social care, and acute hospitals for all patients, including BCYP. In April 2026, NHS England published guidance that sets out actions for ICBs, providers and clinical teams to support safe and effective transition of young people into adolescent and adult services. This includes actions for children in receipt of children and young people’s continuing care. As stated in the NHS England Strategic Commissioning Framework, NHS England is devolving as many of its direct commissioning responsibilities as possible to ICBs to allow them to plan services from end to end, enabling a shift from tertiary towards preventative services. As part of this, within each NHS region an Office of Pan ICB Commissioning is being established as a vehicle through which these direct commissioning responsibilities can be carried out.