Source · Select Committees · Public Accounts Committee
Recommendation 2
2
Only now are the Department and NHS England developing a Modern Service Framework for palliative...
Conclusion
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 England since 2008. The Health and Care Act 2022 set out a legal duty for ICBs to commission palliative care services that meet the needs of the local population, but this has not yet delivered equal access to quality services. Hospices are central to achieving government’s objectives of providing more care in the community and reducing hospital use, but national oversight of the palliative and end-of-life care system has not kept pace with this policy shift. Hospices have diverged 3 from the NHS in some ways, for example, clinicians in hospices are often paid less than their NHS counterparts. The Modern Service Framework that the Department and NHS England are developing aims to bring together disparate elements of the system, including facilitating ICBs to improve their commissioning of care services from hospices, but its details at present are vague, and its delivery will require clear plans and sustained investment to fix the long-standing problems within the sector. recommendation DHSC and NHS England should work with and take on board the views of the hospice sector to develop and publish a fully costed delivery plan alongside the framework.
Government Response
Response Pending
HM Government
Response Pending
The government disagrees with the Committee’s recommendation. Whilst the government agrees that DHSC and NHS England should work with, and take on board, the views of the hospice sector as part of the development of the (modern service) framework (see para 2.3), it does not agree that they should develop and publish a fully costed delivery plan alongside the (modern service) framework (see para 2.4). The government and NHS England agree that the MSF development should include the views of the hospice sector and are working closely with Hospice UK, Marie Curie, Sue Ryder and Together for Short Lives to ensure the views of hospices are gathered and considered at every stage of the MSF development. Stakeholder engagement, including those representing the hospice sector, is running throughout the MSF development. Thus far, officials have worked with stakeholders to develop a working long-term outcome goal (‘moonshot’), an evidence-based listed of interventions and the core components required for the interventions. Progress on the delivery of the MSF will be determined using time-bound measures, which will act as a catalyst to improved data collection across services and experience. A delivery plan will be part of the MSF, which will support the shift to the strategic commissioning of palliative care and end-of-life care, based on the integrated needs assessment completed by the ICB. This supports effective and equitable use of resources on services commissioned and contracted at a local level to meet identified population needs now and in the future. The MSF will provide direction on the evidenced-based interventions that improve outcomes for patients, families and carers. Value for money will be an important consideration in the inclusion of the evidence-based interventions that will support the effective use of resources.