73rd Report - Financial sustainability of adult hospices in England

Select Committee
Public Accounts Committee HC 1236 18 March 2026
Report Status Response document linked Recorded deadline: 18 May 2026

Missing links do not establish that no response was published. A linked document does not verify responses to individual findings.

Conclusions & Recommendations 30 items (16 recs)
Source View on Parliament website

No response data available yet.

Government response
Treasury Minutes: Government response - 73rd Report - Financial sustainability of adult hospices in England
Read the government response ↗ Response on the tracker

Recommendations & Conclusions

30 results
2 Recommendation
Only now are the Department and NHS England developing a Modern Service Framework for palliative...
Recommendation
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 … Read more
HM Treasury
View Details
3 Recommendation
NHS England has been too slow to enforce a commissioning approach for the provision of...
Recommendation
NHS England has been too slow to enforce a commissioning approach for the provision of palliative care that focuses on the quality of outcomes for patients. ICBs continue to fund hospices largely through grants and block contracts, despite the NHS … Read more
HM Treasury
View Details
4 Recommendation
Too many patients spend their last days receiving palliative care in acute hospitals, which does...
Recommendation
Too many patients spend their last days receiving palliative care in acute hospitals, which does not always achieve the best outcomes for patients nor represent value for money. Patients are frequently receiving palliative care and reaching the end of their … Read more
HM Treasury
View Details
5 Recommendation
The Department and NHS England are not responding to the growing financial crisis in the...
Recommendation
The Department and NHS England are not responding to the growing financial crisis in the adult hospice sector with the seriousness and urgency needed. The independent hospice sector is facing a serious financial situation that is already affecting patient care. … Read more
HM Treasury
View Details
6 Recommendation
The NHS is at risk of losing the huge value it gains from independent hospices...
Recommendation
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 … Read more
HM Treasury
View Details
7 Recommendation
Hospice collaboratives have the potential to deliver efficiencies and further raise the quality of care,...
Recommendation
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 … Read more
HM Treasury
View Details
1 Conclusion
On the basis of a report by the Comptroller and Auditor General, we took evidence...
Conclusion
On the basis of a report by the Comptroller and Auditor General, we took evidence from the Department of Health and Social Care (the Department) and NHS England on the provision of palliative and end-of-life care, and the funding of … Read more
HM Treasury
View Details
8 Recommendation
The NAO reported that the mix of funding mechanisms varies between ICB areas, largely comprising...
Recommendation
The NAO reported that the mix of funding mechanisms varies between ICB areas, largely comprising a mix of historic grants and block contracts with few examples of activity-based contracts used in a strategic commissioning approach.11 Progress in moving towards strategic … Read more
HM Treasury
View Details
9 Recommendation
NHS England told us that although it does collect patient-level activity data, it needs to...
Recommendation
NHS England told us that although it does collect patient-level activity data, it needs to start collecting more. It currently does not collect activity data from all hospices and therefore cannot determine how much care ICBs are buying from hospices, … Read more
HM Treasury
View Details
10 Conclusion
There has not been a renewal of the government’s approach to delivering and improving palliative...
Conclusion
There has not been a renewal of the government’s approach to delivering and improving palliative and end-of-life care in England since the first national strategy was published in 2008. The Health and Care Act 2022 introduced a legal duty for … Read more
HM Treasury
View Details
11 Conclusion
The terms and conditions in the independent adult hospice sector have diverged from those in...
Conclusion
The terms and conditions in the independent adult hospice sector have diverged from those in the NHS, with clinicians in hospices often earning less than their NHS counterparts.18 We heard from Hospice UK and NHS England how hospice provision is … Read more
HM Treasury
View Details
12 Recommendation
The Department and NHS England told us that data on patient-level activity from hospices, which...
Recommendation
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 … Read more
HM Treasury
View Details
13 Recommendation
The Department and NHS England told us about the ‘Modern Service Framework’ they are currently...
Recommendation
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 … Read more
HM Treasury
View Details
14 Conclusion
The Department and NHS England are aiming to launch the framework later this year in...
Conclusion
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 … Read more
HM Treasury
View Details
15 Recommendation
ICBs currently fund hospices largely through grants and block contracts, which do not provide clarity...
Recommendation
ICBs currently fund hospices largely through grants and block contracts, which do not provide clarity over what is being purchased.28 The Department and NHS England acknowledged that there must be a move away from funding hospices in this way towards … Read more
HM Treasury
View Details
16 Conclusion
NHS England told us that ICBs are required to understand the needs of their populations...
Conclusion
NHS England told us that ICBs are required to understand the needs of their populations and their projections of future demand.30 NHS England acknowledged that it must take the lead on establishing a single commissioning approach for the provision of … Read more
HM Treasury
View Details
17 Recommendation
Professor Murtagh stressed that ICBs need to commission on the basis of activity and outcomes.
Recommendation
Professor Murtagh stressed that ICBs need to commission on the basis of activity and outcomes. Professor Murtagh explained that this approach is already used elsewhere in the NHS through a blended payment model that aligns payments with incentives, and questioned … Read more
HM Treasury
View Details
18 Recommendation
We are concerned that adult hospices do not benefit from multi-year funding settlements, as children’s...
Recommendation
We are concerned that adult hospices do not benefit from multi-year funding settlements, as children’s hospices do. NHS England agreed that this was an issue, and that it is working towards providing hospices with better certainty over funding over a … Read more
HM Treasury
View Details
19 Conclusion
Professor Murtagh told us that for a long time it has been known that around...
Conclusion
Professor Murtagh told us that for a long time it has been known that around one in four adults who need palliative care do not get it, and that recent research suggests that the proportion may now be even higher.36 … Read more
HM Treasury
View Details
20 Conclusion
The Department and NHS England agreed that there are gaps in provision of palliative and...
Conclusion
The Department and NHS England agreed that there are gaps in provision of palliative and end of life care and that it must meet demand where it is needed.39 They also acknowledged the importance of moving care away from costly … Read more
HM Treasury
View Details
21 Recommendation
Professor Murtagh stressed the importance of having earlier conversations with patients and their families about...
Recommendation
Professor Murtagh stressed the importance of having earlier conversations with patients and their families about possible deterioration and approaching death, to ascertain their wishes. Without such conversations, patients may continue to have high-cost treatment they may not benefit from.43 NHS … Read more
HM Treasury
View Details
22 Conclusion
Some hospices have recently reduced the volume or range of services they provide and others...
Conclusion
Some hospices have recently reduced the volume or range of services they provide and others are planning to do so, at a time when demand for palliative and end-of-life care is rising.45 Hospice UK told us that hospices are facing … Read more
HM Treasury
View Details
23 Conclusion
NHS England emphasised that it is aware that every hospice provider is worried about financial...
Conclusion
NHS England emphasised that it is aware that every hospice provider is worried about financial sustainability, but that it is unaware of any hospices facing immediate closure.50 It told us it expects ICBs to undertake quality impact assessments if a … Read more
HM Treasury
View Details
24 Recommendation
NHS England agreed that the hospice sector is fundamentally in financial distress and that there...
Recommendation
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 … Read more
HM Treasury
View Details
25 Conclusion
The NAO report describes how independent hospices offer additional services that are typically outside the...
Conclusion
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 … Read more
HM Treasury
View Details
26 Conclusion
Baroness Finlay emphasised the role that hospices have as an important source of expertise in...
Conclusion
Baroness Finlay emphasised the role that hospices have as an important source of expertise in palliative and end-of-life care, available to professionals in the NHS such as district nurses and care assistants.58 NHS England told us how hospices support training … Read more
HM Treasury
View Details
27 Conclusion
The Department and NHS England stressed how hospices’ positioning within communities supports the development of...
Conclusion
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 … Read more
HM Treasury
View Details
28 Conclusion
Collaboratives are groups of independent hospices within an ICB region, including Marie Curie, Sue Ryder...
Conclusion
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 … Read more
HM Treasury
View Details
29 Conclusion
We received submissions from three collaboratives: Lancashire & South Cumbria Hospices Together, Greater Manchester Hospices...
Conclusion
We received submissions from three collaboratives: Lancashire & South Cumbria Hospices Together, Greater Manchester Hospices Provider Collaborative, and Cheshire & Merseyside Hospice Provider Collaborative. They described how as collaboratives they can present a united voice to the ICB and are … Read more
HM Treasury
View Details
30 Recommendation
NHS England told us about the West Yorkshire collaborative, which it considers to be the...
Recommendation
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 … Read more
HM Treasury
View Details