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 opportunities for coordinated planning, shared functions, reduced costs through economies of scale and shared management of financial risk. The NAO reported that seven collaboratives are well established across England, with five at an early stage of development. We received submissions from three collaboratives that described how working in partnership across a region reduced needless duplication, minimised unwarranted variation in care, enabled smarter workforce planning and presented a united voice to the ICB. Collaboratives can help ICBs to more readily assess their areas’ overall provision of palliative care and commission services more effectively. NHS England considers the collaborative model to be right for the hospice sector and key to improving care provision. 6 recommendation The Department and NHS England should set out what it can do to support hospices to develop existing collaborative operating models to derive as much financial benefit and service improvement as possible, and to implement collaboration in all areas where it is feasible. 7 1 National oversight and commissioning of palliative and end-of-life care services Introduction