Financial sustainability of adult hospices in England
Public Accounts Committee
Open
Inquiry
Opened: 10 Jul 2025
Parliament page
In 2023, total UK hospice income of £1.8bn comprised around £0.5bn of state funding and the remainder from charitable sources. In 2023-24, many adult hospices reported financial pressures and the threat of needing to cut services by up to 20% unless additional funding was given. An estimated 300 out of …
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16
Recommendations
14
Conclusions
1
Report
1
Oral session
6
Letters
1
Event
Activity timeline 8 events
6 Jul
2026
2026
20 Apr
2026
2026
26 Mar
2026
2026
18 Mar
2026
2026
Report published
26 Jan
2026
2026
26 Jan
2026
2026
26 Jan
2026
2026
12 Jan
2026
2026
Oral evidence
Oral evidence sessions 1 session
12 Jan 2026
View on parliament.uk
Dr Amanda Doyle OBE · NHS England
Dr Edward Scully · Department of Health and Social Care
Duncan Burton · NHS England
Professor Fliss Murtagh · Hull York Medical School
Samantha Jones · Department of Health and Social Care
Sir James Mackey · NHS England
The Baroness Finlay of Llandaff
Toby Porter · Hospice UK
Reports 1 report · click to expand
| Title | HC No. | Published | Items | Response |
|---|---|---|---|---|
| 73rd Report - Financial sustainability of adult hospices in Engl… | HC 1236 | 18 Mar 2026 | 30 | Responded |
Recommendations & Conclusions
11 results
2
Recommendation
Rejected
73rd Report - Financial sustainabi…
Only now are the Department and NHS England developing a Modern Service Framework for palliative...
Only now are the Department and NHS England developing a Modern Service Framework for palliative and end-of-life care, but so far the details are unclear. There has not been a new national strategy for improving palliative and end-of-life care in …
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Government Response
The government disagrees with developing and publishing a fully costed delivery plan alongside the (modern service) framework but that they should work with and take on board the views of the hospice sector as part of the development of the (modern service) framework.
HM Treasury
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6
Recommendation
Rejected
73rd Report - Financial sustainabi…
The NHS is at risk of losing the huge value it gains from independent hospices...
The NHS is at risk of losing the huge value it gains from independent hospices beyond the provision of statutory palliative and end-of-life care. Independent hospices provide enhanced care compared with the NHS, such as complementary therapies, funded from charitable …
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Government Response
The government disagrees, but states that it is working closely with Hospice UK, Marie Curie, Sue Ryder and Together for Short Lives to ensure the views of hospices are gathered and considered at every stage of the MSF development and will also consider high-potential innovation.
HM Treasury
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7
Recommendation
Rejected
73rd Report - Financial sustainabi…
Hospice collaboratives have the potential to deliver efficiencies and further raise the quality of care,...
Hospice collaboratives have the potential to deliver efficiencies and further raise the quality of care, but their development is lacking central support from the Department and NHS England. Some hospices are working together to form collaboratives within ICB regions, offering …
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Government Response
The government recognises that hospice collaboratives can play an important role but states it is not the place of the department or NHS England, to set out the working practices, or operating models, of independent organisations, such as hospices.
HM Treasury
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12
Recommendation
Rejected
73rd Report - Financial sustainabi…
The Department and NHS England told us that data on patient-level activity from hospices, which...
The Department and NHS England told us that data on patient-level activity from hospices, which ICBs need in their role as commissioners, is not strong or robust enough, because hospices are only obliged to report activity data when they are …
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Government Response
The government explicitly disagrees with the committee's recommendation regarding the lack of robust patient-level data from hospices. Its response focuses instead on guidance for ICBs on population health delivery models and the development of new payment models, without addressing the specific data collection or Faster Data Flows concerns.
HM Treasury
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13
Recommendation
Rejected
73rd Report - Financial sustainabi…
The Department and NHS England told us about the ‘Modern Service Framework’ they are currently...
The Department and NHS England told us about the ‘Modern Service Framework’ they are currently developing, which they intend will bring together disparate elements of the system and will set out what “good” commissioning for palliative and end-of-life care looks …
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Government Response
The government explicitly rejects the recommendation to publish a fully costed delivery plan alongside the Modern Service Framework (MSF). While it will include a delivery plan as part of the MSF, it does not commit to it being fully costed.
HM Treasury
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14
Conclusion
Rejected
73rd Report - Financial sustainabi…
The Department and NHS England are aiming to launch the framework later this year in...
The Department and NHS England are aiming to launch the framework later this year in the autumn. However, we are concerned that it will still take time for ICBs to change their commissioning arrangements, a concern reiterated by Sue Ryder …
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Government Response
The government disagrees with the committee's concerns, specifically rejecting the development and publication of a fully costed delivery plan alongside the Modern Service Framework (MSF). It states a delivery plan will be part of the MSF, focusing on effective and equitable use of existing resources without committing new funding.
HM Treasury
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24
Recommendation
Rejected
73rd Report - Financial sustainabi…
NHS England agreed that the hospice sector is fundamentally in financial distress and that there...
NHS England agreed that the hospice sector is fundamentally in financial distress and that there is a need to move quickly to resolve and fix the problems. But it stressed the need to avoid perpetuating problems, such as supporting a …
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Government Response
The government explicitly disagrees with the committee's recommendation for faster action on new payment mechanisms, reiterating that these will be considered as part of the Modern Service Framework. They state it is not their role to make individual plans for independent hospices, but believe the MSF will aid long-term sustainability by moving away from existing funding models.
HM Treasury
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25
Conclusion
Rejected
73rd Report - Financial sustainabi…
The NAO report describes how independent hospices offer additional services that are typically outside the...
The NAO report describes how independent hospices offer additional services that are typically outside the remit of the NHS, for example certain complementary therapies, funded from hospices’ charitable donations. Hospices offer support to the family, friends and carers of those …
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Government Response
The government explicitly disagrees with the committee's observation regarding the additional services and broader contributions of independent hospices. However, the response details ongoing work with hospice charities, the development of the MSF to consider innovation and strategic commissioning, and substantial capital and revenue funding for the hospice sector, which implies an acknowledgement of their value.
HM Treasury
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27
Conclusion
Rejected
73rd Report - Financial sustainabi…
The Department and NHS England stressed how hospices’ positioning within communities supports the development of...
The Department and NHS England stressed how hospices’ positioning within communities supports the development of neighbourhood health services that the NHS 10-year plan is promoting. Hospices are increasingly supporting wider community services, such as care homes and general practice.61 Hospices …
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Government Response
The government explicitly disagrees with the committee's observation. However, it states it is working with the independent hospice sector, considering high-potential innovation within the Palliative Care and End-of-Life Care Modern Service Framework (MSF), and providing significant capital and revenue funding to hospices.
HM Treasury
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28
Conclusion
Rejected
73rd Report - Financial sustainabi…
Collaboratives are groups of independent hospices within an ICB region, including Marie Curie, Sue Ryder...
Collaboratives are groups of independent hospices within an ICB region, including Marie Curie, Sue Ryder and children’s hospices where they are present, which work in partnership, developing a more coordinated approach to the provision of palliative and end-of-life care across …
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Government Response
The government rejects an implied recommendation to intervene in or direct the working practices of hospice collaboratives, stating it's not their role to set the operating models for independent organisations. However, it will consider how to support and spread good practice for these models through the MSF.
HM Treasury
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30
Recommendation
Rejected
73rd Report - Financial sustainabi…
NHS England told us about the West Yorkshire collaborative, which it considers to be the...
NHS England told us about the West Yorkshire collaborative, which it considers to be the most advanced and an example for how hospices in all ICB regions could work in partnership. NHS England pointed to the economies of scale and …
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Government Response
The government explicitly disagrees with the recommendation to encourage or support hospice collaboratives, stating it is not their role to dictate practices for independent organisations. However, they recognise the importance of collaboratives, are considering how to support existing models and spread good practice through the MSF, and will identify and share examples nationally.
HM Treasury
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Correspondence 6 letters
6 Jul 2026
From committee
Letter to the Permanent Secretary at the Department of Health and Social Care and the Chief Executive of NHS England relating to Treasury Minute response – Financial sustainability of adult hospices in England, 6 July 2026
Parliament page
20 Apr 2026
To committee
Letter from the Permanent Secretary of NHS England to the Chair of the Public Accounts Committee relating to Financial stability of adult hospices in England, 30 March 2026
Parliament page
26 Mar 2026
From committee
Letter to the Permanent Secretary at the Department of Health and Social Care relating to Financial sustainability of adult hospices in England, 26 March 2026
Parliament page
26 Jan 2026
To committee
Letter from the Chief Executive Officer of Hospice UK relating to the Committee’s evidence session on 12 January 2026 on Financial Sustainability of Adult Hospices, 15 January 2025
Parliament page
26 Jan 2026
To committee
Letter from the Chief Executive Officer of NHS England relating to the Committee’s evidence session on 12 January 2026 on Financial Sustainability of Adult Hospices, 16 January 2026
Parliament page
26 Jan 2026
To committee
Letter from the Chief Executive Officer of Sue Ryder relating to the Committee’s evidence session on 12 January 2026 on Financial Sustainability of Adult Hospices, 16 January 2026
Parliament page