Recommendations & Conclusions
22 items
1
Conclusion
6th Report - Palliative Care
Accepted
We were highly concerned by the findings of the Expert Panel’s report, which revealed a sector in need of urgent support across all settings, underserving individuals from already vulnerable patient groups. The end of life system is fragmented, difficult to navigate, and leaves individuals in the ‘gap’ between health and …
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We were highly concerned by the findings of the Expert Panel’s report, which revealed a sector in need of urgent support across all settings, underserving individuals from already vulnerable patient groups. The end of life system is fragmented, difficult to navigate, and leaves individuals in the ‘gap’ between health and social care all too often. Without safeguards, the Government’s intention to shift palliative care to the community risks placing further unsustainable pressure on the community workforce, who are already overworked and under capacity. (Conclusion, Paragraph 8) The Modern Service Framework
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Government response AI summary
The government accepts the concerns, stating it will develop accountability arrangements with the National Quality Board, refresh statutory guidance and service specifications later this year, and expect ICBs to complete integrated needs assessments to address the issues.
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Department of Health and Social Care
2
Conclusion
6th Report - Palliative Care
Accepted
We welcome the Government’s plans to introduce a Modern Service Framework to set national standards for palliative and end of life care services, and the Department’s commitment to co-produce this work alongside key stakeholders. However, we approach this with a level of scepticism, given the number of issues this Framework …
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We welcome the Government’s plans to introduce a Modern Service Framework to set national standards for palliative and end of life care services, and the Department’s commitment to co-produce this work alongside key stakeholders. However, we approach this with a level of scepticism, given the number of issues this Framework purports to resolve, and the risk the Government runs if this is not achieved. (Conclusion, Paragraph 16)
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Government response AI summary
The government recognises variable access to palliative care for children and young people and states the MSF will provide a framework for improvement with specific metrics. They will refresh statutory guidance and service specifications later this year to support ICB commissioning, and NHS England published …
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Department of Health and Social Care
3
Conclusion
6th Report - Palliative Care
Not Addressed
We are unclear about what is fundamentally different about this framework compared to existing documents, such as the Ambitions Framework and the NHS National Standards for Palliative and End of Life Care. In particular, what different approach it will take to ensure that the Framework is effectively implemented across ICBs …
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We are unclear about what is fundamentally different about this framework compared to existing documents, such as the Ambitions Framework and the NHS National Standards for Palliative and End of Life Care. In particular, what different approach it will take to ensure that the Framework is effectively implemented across ICBs and setting out the consequences of inaction. (Conclusion, Paragraph 17)
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Government response AI summary
The government response discusses existing and refreshed guidance for 24/7 palliative and end-of-life care services and out-of-hours medicines access, but does not clarify the unique aspects of the Modern Service Framework or its implementation and accountability.
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Department of Health and Social Care
4
Recommendation
6th Report - Palliative Care
Not Addressed
If the Modern Service Framework is to deliver meaningful change it must be more than a well-intentioned ambition. ICBs and the Department need to be held accountable for meeting the Framework, with clear consequences if its standards are not met. We call on the Government to set out, in its …
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If the Modern Service Framework is to deliver meaningful change it must be more than a well-intentioned ambition. ICBs and the Department need to be held accountable for meeting the Framework, with clear consequences if its standards are not met. We call on the Government to set out, in its interim Report this Spring, what accountability arrangements will be in place to support implementation of the MSF and what concrete steps the 35 Department will take with ICBs that fall short. The Government must also ensure that ICBs have the support, tools and resources they need to deliver on the MSF. (Recommendation, Paragraph 18) Commissioning
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Government response AI summary
The government's response pivots to discussing changes in ICB and local authority collaboration, focusing on the Neighbourhood Health Framework and 'place' level working. It does not address the committee's specific recommendation regarding accountability arrangements or consequences for ICBs failing to meet the Modern Service Framework …
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Department of Health and Social Care
5
Recommendation
6th Report - Palliative Care
Rejected
We are concerned that the Minister was unable to commit to providing clear and specific standards and guidance for babies, children and young people’s palliative and end of life care in the Modern Service Framework (MSF). We strongly recommend that the Department includes specific standards within the MSF for the …
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We are concerned that the Minister was unable to commit to providing clear and specific standards and guidance for babies, children and young people’s palliative and end of life care in the Modern Service Framework (MSF). We strongly recommend that the Department includes specific standards within the MSF for the provision of children and young people’s palliative care services, and for the transition between child and adult services. Pan-ICB commissioning guidance should contain specific information on how to commission these services effectively. (Recommendation, Paragraph 26)
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Government response AI summary
The government rejects the recommendation to include specific standards and commissioning guidance for children and young people's palliative care within the Modern Service Framework. It states it is considering targets and metrics as the full MSF is developed, focusing on early identification of palliative care …
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Department of Health and Social Care
6
Conclusion
6th Report - Palliative Care
Not Addressed
It is unacceptable that access to 24/7 palliative and end of life care services remains patchy throughout England. Individuals nearing the end of life should be able to access the right care, advice and medication, wherever they are and regardless of the time of day. We are pleased that the …
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It is unacceptable that access to 24/7 palliative and end of life care services remains patchy throughout England. Individuals nearing the end of life should be able to access the right care, advice and medication, wherever they are and regardless of the time of day. We are pleased that the Minister committed to 100% telephone line coverage in England by 2027, but this is not enough. While telephone advice lines provide support and may prevent unnecessary hospital admissions, they are insufficient to build a resilient and effective out of hours palliative care service on their own. (Conclusion, Paragraph 35)
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Government response AI summary
The government response discusses the importance of data and dashboards for commissioning and performance oversight, but does not address the committee's specific concern about patchy 24/7 palliative and end-of-life care services beyond telephone lines.
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Department of Health and Social Care
7
Recommendation
6th Report - Palliative Care
Not Addressed
We recommend that the MSF includes specific guidelines and requirements for ICBs to enable access to 24/7 PEoLC services, including access to symptomatic medication, and in-person care where necessary. We call on the Government to provide an assessment of both the workforce needed to deliver such a service and the …
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We recommend that the MSF includes specific guidelines and requirements for ICBs to enable access to 24/7 PEoLC services, including access to symptomatic medication, and in-person care where necessary. We call on the Government to provide an assessment of both the workforce needed to deliver such a service and the potential savings to the wider health and care service that such an offer would deliver. (Recommendation, Paragraph 36)
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Government response AI summary
The government response discusses the Single Patient Record and its legislative framework, but it does not address the recommendation to include specific guidelines in the MSF for 24/7 PEoLC services or to provide an assessment of the workforce and potential savings.
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Department of Health and Social Care
8
Recommendation
6th Report - Palliative Care
Not Addressed
The role of social care in the provision of palliative and end of life care has been overlooked for far too long, and we are concerned that the Government’s plans to remove local authorities from ICBs will only make the current situation worse, particularly in the context of the Government’s …
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The role of social care in the provision of palliative and end of life care has been overlooked for far too long, and we are concerned that the Government’s plans to remove local authorities from ICBs will only make the current situation worse, particularly in the context of the Government’s aim to shift care into the community. We urge the Government to reconsider its decision to remove, through legislation, local authority representation on ICBs, to ensure social care is represented, understood and appropriately commissioned to deliver end of life care. (Recommendation, Paragraph 41) 36 Data
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Government response AI summary
Despite a 'Partially Accept' label, the government's response discusses generalist workforce training and education frameworks for healthcare professionals, which does not address the recommendation to reconsider removing local authority representation on ICBs.
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Department of Health and Social Care
9
Conclusion
6th Report - Palliative Care
Not Addressed
We support increasing use of the Palliative Care Register for early identification of individuals, including children and young people with PEoLC needs. However, we are concerned that its use is likely to decrease given the removal of funding incentives for primary care practitioners to add patients to the Register. (Conclusion, …
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We support increasing use of the Palliative Care Register for early identification of individuals, including children and young people with PEoLC needs. However, we are concerned that its use is likely to decrease given the removal of funding incentives for primary care practitioners to add patients to the Register. (Conclusion, Paragraph 45)
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Government response AI summary
The government response discusses bereavement services and ICB oversight for their delivery, but it does not address the committee's concern regarding the Palliative Care Register or the impact of removing funding incentives for its use.
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Department of Health and Social Care
10
Recommendation
6th Report - Palliative Care
Not Addressed
We recommend that the Department implement the 90% target for the percentage of individuals in the last year of life documented on the Palliative Care Register and that it reports annually on progress against this target to monitor the impact of its decision to remove the financial incentive to add …
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We recommend that the Department implement the 90% target for the percentage of individuals in the last year of life documented on the Palliative Care Register and that it reports annually on progress against this target to monitor the impact of its decision to remove the financial incentive to add patients to the Register. (Recommendation, Paragraph 46)
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Government response AI summary
The government response outlines plans for sustainable funding and commissioning for hospices, including a move away from short-term grant funding from 2027/28, but does not address the recommendation for a 90% target for the Palliative Care Register or annual reporting.
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Department of Health and Social Care
11
Conclusion
6th Report - Palliative Care
Accepted
National palliative and end of life care data provide valuable insight into patterns of healthcare use and location of death, however the evidence presented demonstrates substantial gaps in local data collection and utilisation. Without consistent, granular and timely data, ICBs and providers cannot reliably commission, plan, or improve palliative and …
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National palliative and end of life care data provide valuable insight into patterns of healthcare use and location of death, however the evidence presented demonstrates substantial gaps in local data collection and utilisation. Without consistent, granular and timely data, ICBs and providers cannot reliably commission, plan, or improve palliative and end of life services in line with their population needs. (Conclusion, Paragraph 51)
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Government response AI summary
The government agrees on the importance of data, noting NHS England is strengthening expectations and providing tools. From April 2026, ICBs are expected to use comprehensive data for commissioning, and the MSF will set clearer expectations for data use and accountability.
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Department of Health and Social Care
12
Recommendation
6th Report - Palliative Care
Accepted
We urge the department to mandate ICBs to maintain a fully populated palliative and end of life care dashboard that is actively used for commissioning, service planning, quality improvement, and inequality monitoring across their local system. (Recommendation, Paragraph 52)
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We urge the department to mandate ICBs to maintain a fully populated palliative and end of life care dashboard that is actively used for commissioning, service planning, quality improvement, and inequality monitoring across their local system. (Recommendation, Paragraph 52)
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Government response AI summary
The government agrees and states that from April 2026, ICBs are expected to use comprehensive data and a palliative and end-of-life care dashboard for commissioning, service planning, and monitoring, with a goal to embed its active use.
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Department of Health and Social Care
13
Conclusion
6th Report - Palliative Care
Accepted
Poor data sharing and lack of integration across NHS, social care, voluntary and private providers creates confusion, delays and gaps in continuity for people at the end of life, frequently placing the burden of coordination care on patients and carers during what is an extremely emotional and challenging period. Despite …
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Poor data sharing and lack of integration across NHS, social care, voluntary and private providers creates confusion, delays and gaps in continuity for people at the end of life, frequently placing the burden of coordination care on patients and carers during what is an extremely emotional and challenging period. Despite existing systems for data sharing, inconsistent uptake, poor interoperability and limited outcome-level information reduce effectiveness. (Conclusion, Paragraph 55)
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Government response AI summary
The government agrees on the importance of integrated palliative care and outlines plans for a Single Patient Record to bring together patient information across health and social care. They will introduce legislation to enable all providers, including private and voluntary sectors, to contribute to and …
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Department of Health and Social Care
14
Recommendation
6th Report - Palliative Care
Accepted
If the Government intends for the introduction of the Single Patient Record to address concerns about a lack of service integration for palliative and end of life care, then this record must be available to all providers—including social care, the voluntary sector and private providers. The Government should also set …
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If the Government intends for the introduction of the Single Patient Record to address concerns about a lack of service integration for palliative and end of life care, then this record must be available to all providers—including social care, the voluntary sector and private providers. The Government should also set out in its response to this Report how it will use the introduction of the Single Patient Record to drive integration across different types of providers. (Recommendation, Paragraph 56) 37 Workforce
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Government response AI summary
The government accepts the recommendation and will bring forward legislation to enable all health and social care providers, including private and voluntary sectors, to contribute to and access the Single Patient Record as the program develops.
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Department of Health and Social Care
15
Conclusion
6th Report - Palliative Care
Accepted
Generalist staff, who provide most end of life care, often lack the skills, confidence and specialist support required to deliver high-quality, person-centred care. Despite existing initiatives, a clearer, system-wide approach to upskilling the generalist workforce is urgently needed. (Conclusion, Paragraph 63)
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Generalist staff, who provide most end of life care, often lack the skills, confidence and specialist support required to deliver high-quality, person-centred care. Despite existing initiatives, a clearer, system-wide approach to upskilling the generalist workforce is urgently needed. (Conclusion, Paragraph 63)
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Government response AI summary
The government is committed to training staff, noting an existing career pathway and core capabilities framework developed by NHS England, and is working to commission QiSS modules with funding and places planned for March 2027/28 to upskill the generalist workforce.
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Department of Health and Social Care
16
Recommendation
6th Report - Palliative Care
Accepted in Part
We recommend that end of life care be included as a core skill for the generalist health and social care workforce, with a clear and defined set of competencies required to deliver high-quality and person-centred palliative and end of life care. This should be reflected in the forthcoming 10 Year …
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We recommend that end of life care be included as a core skill for the generalist health and social care workforce, with a clear and defined set of competencies required to deliver high-quality and person-centred palliative and end of life care. This should be reflected in the forthcoming 10 Year Workforce Plan. In particular, the critical role that social care staff play in delivering palliative care should be acknowledged in the Plan, and reflected in the training and support social care staff receive to enable them to provide this care in a more systematic way. While we welcome the Qualification in Specialism Standard for Palliative and End-of-Life Care, we ask the Department to provide further information in its response to this Report on who will be required to complete this training and when it will become available. (Recommendation, Paragraph 64)
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Government response AI summary
The government partially accepts, committing to integrating palliative care into generalist practice and education, as reflected in the 10 Year Workforce Plan and an NHS England education framework. A career pathway and core capabilities framework for specialist palliative care are available, with funding and places …
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Department of Health and Social Care
17
Recommendation
6th Report - Palliative Care
Accepted in Part
Current shortages in the specialist workforce are putting palliative care services in an unsustainable position which threatens their ability to deliver equitable and high-quality palliative and end of life care. Extensive consultant vacancies, impending retirements, limited training places and widespread nursing shortages all contribute to an inability to meet demand, …
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Current shortages in the specialist workforce are putting palliative care services in an unsustainable position which threatens their ability to deliver equitable and high-quality palliative and end of life care. Extensive consultant vacancies, impending retirements, limited training places and widespread nursing shortages all contribute to an inability to meet demand, with particular staff shortages experienced in children and young people’s palliative care. This is an unacceptable situation, and urgent action is needed address these shortages. (Conclusion, Paragraph 68)
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Government response AI summary
The government partially accepts, focusing on training for the generalist workforce and developing a Qualification in Specialism Standard (QiSS) for palliative care. They plan to have funding and places for QiSS modules ready by March 2027/28, and a career pathway framework is already available.
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Department of Health and Social Care
18
Recommendation
6th Report - Palliative Care
Accepted in Part
The Government need to publish an evidence-based plan, supported by up-to-date workforce modelling, setting out how it will increase the capacity and sustainability of all sectors of the specialist palliative and end of life care workforce, as part of the 10 Year Workforce Plan. This should include plans for clear …
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The Government need to publish an evidence-based plan, supported by up-to-date workforce modelling, setting out how it will increase the capacity and sustainability of all sectors of the specialist palliative and end of life care workforce, as part of the 10 Year Workforce Plan. This should include plans for clear training pathways and a specific target for the staffing of children and young people’s palliative care. (Recommendation, Paragraph 69) Bereavement
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Government response AI summary
The government partially accepts the recommendation, highlighting the 10 Year Long Term Workforce Plan's focus on integrating palliative care into generalist education. It mentions an existing career pathway framework for specialist palliative care and plans for funding and places for the Qualification in Specialism Standard …
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Department of Health and Social Care
19
Conclusion
6th Report - Palliative Care
Acknowledged
Bereavement, and pre-bereavement support are essential, yet access remains patchy, poorly commissioned, and often difficult to navigate. Despite its inclusion in the current Ambition Framework, significant gaps persist, particularly for culturally diverse communities and children and young people. (Conclusion, Paragraph 75) 38
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Bereavement, and pre-bereavement support are essential, yet access remains patchy, poorly commissioned, and often difficult to navigate. Despite its inclusion in the current Ambition Framework, significant gaps persist, particularly for culturally diverse communities and children and young people. (Conclusion, Paragraph 75) 38
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Government response AI summary
The government agrees in principle on the importance of bereavement support, noting existing ICB responsibilities, frameworks, and statutory guidance. While the MSF will reinforce the need, there are no plans for new monitoring outside of current ICB oversight arrangements.
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Department of Health and Social Care
20
Recommendation
6th Report - Palliative Care
Accepted
The Government must hold ICBs to account for delivering bereavement services. This does not need to wait for the forthcoming Modern Service Framework as there are already clearly defined expectations for what ICBs should deliver in this area. In its response to this Report, we ask that the Department sets …
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The Government must hold ICBs to account for delivering bereavement services. This does not need to wait for the forthcoming Modern Service Framework as there are already clearly defined expectations for what ICBs should deliver in this area. In its response to this Report, we ask that the Department sets out how it will monitor ICBs’ current delivery of bereavement services, and what steps will be taken with ICBs that do not deliver an acceptable level of service. (Recommendation, Paragraph 76) Hospices
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Government response AI summary
The government agrees in principle on the importance of robust bereavement services and states that oversight mechanisms are already in place to hold ICBs accountable, but there are currently no plans to further monitor current delivery beyond existing arrangements.
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Department of Health and Social Care
21
Recommendation
6th Report - Palliative Care
Accepted
Hospices form an integral part of palliative and end of life care provision at home and in the community and we welcome the fact that the Government intends for them to play a bigger role as part of its shift to neighbourhood health. However, if the Government want hospices to …
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Hospices form an integral part of palliative and end of life care provision at home and in the community and we welcome the fact that the Government intends for them to play a bigger role as part of its shift to neighbourhood health. However, if the Government want hospices to deliver a universal and equitable service, this must be matched with additional resources. We were unconvinced by the Government’s argument that this will be addressed simply by improving the data that ICBs have access to. (Conclusion, Paragraph 83)
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Government response AI summary
The government agrees hospices are vital and will use the MSF to support a move towards sustainable and predictable funding models for them. ICBs are asked to transition to sustainable contracting of hospice services, including moving away from short-term grant funding for adult hospices by …
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Department of Health and Social Care
22
Recommendation
6th Report - Palliative Care
Accepted
We recommend that the Government moves towards sustainable and predictable models of funding for hospices, financing their running as well as investment costs, which reflects the increasingly central role they will play in delivering end of life care. This funding should be accompanied by conditions that require hospices to play …
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We recommend that the Government moves towards sustainable and predictable models of funding for hospices, financing their running as well as investment costs, which reflects the increasingly central role they will play in delivering end of life care. This funding should be accompanied by conditions that require hospices to play a greater role in actively addressing inequalities in access to their services. (Recommendation, Paragraph 84) 39
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Government response AI summary
The government agrees to move towards sustainable and predictable funding models for hospices, using the MSF to support ICBs in reviewing commissioning and contracting. ICBs are asked to move to sustainable contracting, with a shift away from short-term grant funding for adult hospices by 2027/28, …
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Department of Health and Social Care