73rd Report - Financial sustainability of adult hospices in England

NHS England published statutory guidance for palliative care and end-of-life care, as well as service specifications. NHS England will work with some ICBs to develop new payment models to support neighbourhood services, including for the high- priority cohorts, including those at end of life. The government is developing a Palliative Care and End-of-Life Care MSF, through which we will closely monitor the shift towards strategic commissioning.

The government is developing a Palliative Care and End‑of‑Life Care MSF which will support the shift to strategic commissioning based on integrated needs assessments and will outline evidenced based interventions. It will also build on the recently published Neighbourhood Health Framework, which sets clear expectations for the improvement of care of palliative care and end-of-life care patients through Neighbourhood Health.

The government agrees with the committee’s recommendation: service specifications for adults and children and young people, outlining expectations of what palliative care and end-of-life care services are commissioned.

The government agrees with the committee's recommendation to address slow progress in strategic commissioning and reform funding mechanisms, with an implementation target of Autumn 2026. It plans to use the Palliative Care and End-of-Life Care Modern Service Framework (MSF) to strengthen commissioning and improve sustainability by moving away from grant and block contract models, and has already published related guidance.

The government accepts the recommendation to improve data collection and address the over-reliance on charitable funding for hospices. It plans to achieve this through the Palliative Care and End-of-Life Care Modern Service Framework (MSF), slated for Autumn 2026, and the Strategic Commissioning Framework, which will strengthen commissioning and facilitate a move away from grant and block contract models.

The government agrees with the committee's observation and is developing a Palliative Care and End-of-Life Care Modern Service Framework (MSF) for monitoring strategic commissioning. NHS England has already published guidance and frameworks, and will work with some ICBs to develop new payment models by Autumn 2026.

The government agrees with the committee's finding, stating that ICBs have a duty to commission palliative care, supported by statutory guidance and NHS England's new strategic commissioning framework. This framework, with a target implementation date of Autumn 2026, aims to address governance issues in hospice provision.

The government accepts the recommendation to move away from grants and block contracts towards a strategic commissioning approach for hospices. It plans to address this through the Palliative Care and End-of-Life Care Modern Service Framework (MSF), due for publication in Autumn 2026, which aims to strengthen commissioning and improve sustainability.

The government agrees with the committee's findings, detailing existing and planned initiatives by NHS England to support ICBs in strategic commissioning. These include a Strategic Commissioning Framework, statutory guidance, and a forthcoming Palliative Care and End-of-Life Care MSF by Autumn 2026.

The government accepts the recommendation for ICBs to commission palliative and end-of-life care based on activity and outcomes. It outlines multiple existing frameworks and guidance, commits NHS England to developing new payment models with ICBs, and plans for the Palliative Care and End-of-Life Care MSF (Autumn 2026) to monitor the shift towards strategic commissioning.

The government accepts the recommendation, agreeing that multi-year funding is an issue. It plans to address this through the Palliative Care and End-of-Life Care Modern Service Framework (MSF), slated for publication in Autumn 2026, which aims to strengthen commissioning and move away from current funding models.

The government accepts the implied recommendation to improve access to palliative care and shift care out of acute hospital settings. It plans to achieve this through the Palliative Care and End-of-Life Care MSF by Autumn 2026, which will include metrics to reduce avoidable hospital admissions and unnecessary bed days, building on existing frameworks with a 10% target for these improvements.

The government accepts the implied recommendation to address gaps in palliative and end-of-life care provision and to rebalance funding away from the acute sector. It plans to achieve this through the Palliative Care and End-of-Life Care MSF by Autumn 2026, which will include metrics to reduce avoidable hospital admissions and unnecessary bed days, building on existing frameworks with a 10% target for these improvements.

The government agrees with the recommendation, setting an Autumn 2026 target implementation date, and is developing a Palliative Care and End-of-Life Care MSF and building on existing frameworks to support earlier conversations and advanced care plans for patients.

The government accepts the implied recommendation to address financial pressures leading to service reductions in hospices. It details existing actions, including NHS England's request for ICB assessments on hospice financial stability, and ICBs' reported commitments to prevent service closures through various financial, operational, and governance measures.

The government accepts the implied recommendation regarding hospice financial stability. It outlines existing actions, such as NHS England requesting financial stability assessments from ICBs and ICBs' commitments to prevent service closures through various financial, operational, and governance actions.

Despite stating disagreement with the conclusion, the government's response outlines strong support for hospices, including close collaboration on the Modern Service Framework (MSF) and substantial funding. It is providing £125 million in capital funding and approximately £80 million in revenue funding for children and young people's hospices.