Accept We know that having 24/7 access to palliative care and end-of-life care support benefits patients, families and healthcare professionals who do not have that specialist experience and expertise. Specific guidelines on 24/7 palliative care and end-of-life care services are already available via NHS England’s statutory guidance which already makes specific reference to commissioners defining how their services will meet population needs 24/7, and includes a priority action for ensuring that staff, patients and carers can access the care and advice they need, whatever time of day. We will be refreshing this guidance later this year. Additionally, NICE guidance on end-of-life care for adults includes recommendations about 24/7 access to care. It recommends that adults approaching the end of their life should have access to an out-of-hours end of life care advice line and a healthcare professional available 24 hours a day, 7 days a week, who can access the person’s records and advance care plan, and make informed decisions about changes to care. Although NICE guidance is not mandatory, there is an expectation that commissioners and service providers take the guidelines into account when making decisions about how to best meet the needs of their local communities. We are committed to publishing an MSF to improve the access, quality and sustainability of all-age palliative care and end-of-life care in line with the 10 Year Health Plan, and 24/7 provision has been identified an area of action that can help to achieve our goal of improving palliative care and end- of-life care for all by reducing A&E attendances, non-elective admissions and bed days in last 90 days of life. Furthermore, through our work on neighbourhood health, we will set out how evidence-based models can be adopted and scaled. Our forthcoming 10 Year Workforce Plan will ensure the NHS has the right people in the right places, with the right skills to care for patients, when they need it. We are working with partners to ensure the Plan delivers for staff and patients. We are also engaging independent experts to ensure it is ambitious, forward-looking and evidence-based. We continue to work through how the Plan, due to be published soon, will articulate the changes for different professional groups and service areas by setting out specific measures. We also recognise the vital role community pharmacy plays in supporting people at the end of life, including timely access to medicines and advice for patients, families and carers. Most community pharmacies are contracted to open for a minimum of 40 hours a week, with others open at least 72 hours, with around 80% of the public living within 20 minutes’ walk. This ensures access across a wide range of times, generally from 5pm to 9pm, Monday to Saturday, and from 11am to 4pm on Sundays. While a 24/7 level of provision is not covered by the terms of service requirements for community pharmacies that provide NHS services, local ICBs can, and already do, commission out-of-hours dispensing locally if there is a need for patients to access medicines outside of the core pharmacy hours. In urgent situations, where it is not possible to collect the medication from a pharmacy or primary care provider, patients can attend hospital A&E departments. We will continue to work with system partners, the palliative care and end- of-life-care sector and community pharmacy representatives to improve consistency of access, including reviewing what further national support or guidance is needed to reduce unwarranted variation and strengthen outofhours medicines access for people nearing the end of life.