Variations in the delivery of palliative care services to adults

As with Joint Strategic Needs Assessment (JSNA), Integrated Care Boards (ICBs) are free to understand their populations’ demographics and needs in a way best suited to their local circumstances. There is no template, format or mandatory data that must be used. As with JSNAs, a range of quantitative and qualitative evidence is encouraged for a detailed understanding of population need. There are a number of data sources and tools for quantitative data. These were listed by NHS England in their response. Qualitative information can be gained via, including but not limited to, co-production, surveys and events with people with lived experience. Updated response: Since the initial response, NHS England has worked to recommission an ICB-level dashboard that pulls together relevant data streams from primary and secondary care. This enables ICBs to better understand their population needs and to help plan services in their footprints. The data can be manipulated to explore aspects relating to service lines, service utilisation, population information, etc. Funding to renew the data quarterly for 2024/25 has been confirmed. The dashboard is available on the FutureNHS Collaboration Platform. Response received on 6 October 2023 and updated on 26 July 2024.

As stated in the Health and Care Act 2022, palliative and end of life care is commissioned by Integrated Care Boards (ICBs) in response to the needs of their local population. Consequently, some degree of variability is expected in order to effectively respond to differing population needs. However, there are a number of resources available to guide and support commissioners and providers in understanding and achieving high-quality palliative and end of life care. These resources were listed by NHS England in their response, alongside published palliative and end of life care service specifications for children and young people and adults. Updated response: ICB engagement is recognised as a key focus area and ongoing work is underway over the next 18 months. A variety of resources are available to commissioners on the FutureNHS Collaboration Platform, including a Commissioning and Investment Framework. This seeks to support local clarity on services available and the likely providers. Response received on 6 October 2023 and updated on 26 July 2024.

Work is being undertaken by NHS England to develop a allied health professional (AHP) career pathway that includes developmental education and training programmes. Palliative and end of life care will be built into these as possible, AHPs work across many areas and need this knowledge and skill, specialist roles require access to broad multiprofessional palliative care training and also require barriers to practice (e.g. prescribing) to be revised. The barrier to workforce development is the resource to develop training programmes, and to train, supervise and employ staff in these roles. A multi-professional advanced practice training pathway for adult end of life care has been developed and is in the process of seeking an implementation partner, this will include the allied health professions. However, funding for advanced practice training roles and posts on qualification is a challenge. Response received on 20 October 2023 and updated on 29 July 2024.