Palliative care data gaps

#14 —

Justice Committee

Recommendation: The ageing prison population has and will continue to increase the need for end-of- life and palliative care in prisons. We welcome the publication of the Dying Well in Custody Charter and the good practice at some establishments. But standards …

Gov response: End-of-life and palliative care • HMPPS work with NHS England to identity men and women in our care who are at or near the end of their life, to ensure that services are in place …

Position Not Stated

#12 —

Public Accounts Committee

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 …

Gov response: 1.3 The government disagrees with the Committee’s recommendation: 1.4 Guidance on how ICBs can move towards population health delivery models and commissioning was also published alongside the Neighbourhood Health Framework on 17 March 2026. This …

Not Accepted

#12 —

Health and Social Care Committee

Recommendation: 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)

Gov response: Accept We agree that high-quality, consistent data is essential to effective commissioning, service planning, quality improvement and understanding and addressing inequalities in palliative care and end-of-life care. NHS England provides national data tools via a …

Position Not Stated

#11 —

Health and Social Care Committee

Recommendation: 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 …

Gov response: Accept We agree that high-quality, consistent data is essential to effective commissioning, service planning, quality improvement and understanding and addressing inequalities in palliative care and end-of-life care. NHS England provides national data tools via a …

Response Not Attributed

#27 — Departmental annual report shows significant omissions on preventative and end-of-life care.

Public Accounts Committee

Recommendation: The NHS Long Term Plan states that ill health prevention helps the public to stay healthy, as well as moderating demands on the NHS. The Department recognised in its 2023–24 Annual Report that there “is still much work to do …

Gov response: 2.1 The government agrees with the Committee’s recommendations. Target implementation date: September 2025 2.2 The department is committed to the continuous improvement of its Annual Report and Accounts (ARA) to ensure the content is as …

Accepted

#15 —

Justice Committee

Recommendation: Prisoners applying for early release on compassionate grounds should have their applications processed in an efficient and timely manner. This is especially important for terminally ill prisoners near the end of their lives. We recommend prisons identify a single member …

Gov response: Early Release on Compassionate Grounds • The Secretary of State may release a prisoner on licence at any point in the sentence if he is satisfied that this is justified by “exceptional circumstances”. Early Release …

Response Not Attributed

#25 —

Public Accounts Committee

Recommendation: 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 …

Gov response: The government disagrees with the Committee’s recommendation. The government and NHS England are working closely with Hospice UK, Marie Curie, Sue Ryder and Together for Short Lives to ensure the views of hospices are gathered …

Not Accepted

#22 —

Public Accounts Committee

Recommendation: 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 …

Gov response: 5.1 The government agrees with the Committee’s recommendation: Target implementation date: Autumn 2026 5.2 Earlier this year, NHS England wrote to all ICBs requesting an update on the financial stability of hospices in their footprint, …

Accepted

#19 —

Public Accounts Committee

Recommendation: 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 …

Gov response: 4.1 The government agrees with the Committee’s recommendation. Target implementation date: Autumn 2026 4.2 The government is determined to shift more healthcare out of hospitals and into the community, to ensure patients and their families …

Accepted

#17 —

Public Accounts Committee

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 …

Gov response: 3.1 The government agrees with the Committee’s recommendation. Target implementation date: Autumn 2026 3.2 Last year, NHS England published a Strategic Commissioning Framework, supporting ICBs to respond effectively to current and future needs of their …

Accepted

#9 —

Public Accounts Committee

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, …

Gov response: The government disagrees with the Committee’s recommendation. Guidance on how ICBs can move towards population health delivery models and commissioning was also published alongside the Neighbourhood Health Framework on 17 March 2026. This states that …

Accepted

#1 —

Public Accounts Committee

Recommendation: 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 …

Gov response: 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. This is further supported by NHS England’s …

Accepted

#5 —

Public Accounts Committee

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. …

Gov response: The government disagrees with the Committee’s recommendation: It is not for the government to make individual plans for each independent hospice. The government and NHS England will consider contracting and commissioning arrangements, including that of …

Not Accepted

#4 —

Public Accounts Committee

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 …

Gov response: The government agrees with the Committee’s recommendation. community, to ensure patients and their families receive personalised care in the most appropriate setting, and palliative care and end-of-life care services, including hospices, will have a big …

Accepted

#2 —

Public Accounts Committee

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 …

Gov response: 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 …

Not Accepted

#22 —

Health and Social Care Committee

Recommendation: 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 …

Gov response: Accept The Government recognises the vital role that hospices play, alongside NHS services, in supporting people at the end of life. Through recent investment and wider reforms, we are taking steps to support both service …

Position Not Stated

#20 —

Health and Social Care Committee

Recommendation: 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 …

Gov response: Accept The Government recognises the significance of bereavement support for families and friends following the loss of a loved one and agrees in principle with the recommendation, recognising the importance of robust bereavement services. Oversight …

Position Not Stated

#19 —

Health and Social Care Committee

Recommendation: 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 …

Gov response: Accept The Government recognises the significance of bereavement support for families and friends following the loss of a loved one and agrees in principle with the recommendation, recognising the importance of robust bereavement services. Oversight …

Response Not Attributed

#18 —

Health and Social Care Committee

Recommendation: 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 …

Gov response: Partially Accept Specialist workforce The 10 Year Workforce Plan will set out action to ensure we have a sustainable workforce ready to deliver the transformed service set out in the 10 Year Health Plan. We …

Response Not Attributed

#17 —

Health and Social Care Committee

Recommendation: 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 …

Gov response: Partially Accept Specialist workforce The 10 Year Workforce Plan will set out action to ensure we have a sustainable workforce ready to deliver the transformed service set out in the 10 Year Health Plan. We …

Response Not Attributed

#16 —

Health and Social Care Committee

Recommendation: 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 …

Gov response: Partially Accept Generalist Workforce We are committed to training the staff we need to ensure patients are cared for by the right professional, when and where they need it. Standards of proficiency, conduct and performance …

Partially Accepted

#10 —

Health and Social Care Committee

Recommendation: 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 …

Gov response: Reject While there is currently no formal government target of 90% for the percentage of individuals in the last year of life documented on the Palliative Care Register, the evidence suggests that between 0.75% – …

Position Not Stated

#9 —

Health and Social Care Committee

Recommendation: 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 …

Gov response: Reject While there is currently no formal government target of 90% for the percentage of individuals in the last year of life documented on the Palliative Care Register, the evidence suggests that between 0.75% – …

Response Not Attributed

#7 —

Health and Social Care Committee

Recommendation: 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 …

Gov response: Accept We know that having 24/7 access to palliative care and end-of-life care support benefits patients, families and healthcare professionals who do not have that specialist experience and expertise. Specific guidelines on 24/7 palliative care …

Position Not Stated

#6 —

Health and Social Care Committee

Recommendation: 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 …

Gov response: Accept We know that having 24/7 access to palliative care and end-of-life care support benefits patients, families and healthcare professionals who do not have that specialist experience and expertise. Specific guidelines on 24/7 palliative care …

Response Not Attributed

#5 —

Health and Social Care Committee

Recommendation: 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 …

Gov response: Accept We recognise that access to high-quality palliative care and end-of-life care for BCYP, and those transitioning between children’s and adult services is variable. The MSF will provide an all age, clinically-led, evidence-based framework to …

Position Not Stated

#53 — Record detailed post-16 pathway and long-term outcome data for care-experienced individuals.

Education Committee

Recommendation: The Department must record data on post-16 pathways and attainment for those with care experience—including detailed data on qualifications, course types and completion rates. The Department should also monitor long-term outcomes—employment quality, income levels, and 100 higher education progression for …

Gov response: PLANS ALREADY IN PLACE The Department acknowledges the importance of robust data collection to improve outcomes for care-experienced young people. As set out below, the Department already records and monitors a range of data, which …

Position Not Stated

#6 — Skills England faces challenges with data collection, levy system, and programme communication.

Education Committee

Recommendation: Skills England has been broadly welcomed by the further education and skills sectors. We agree with the Government’s priorities for Skills England, including identifying national and local skills needs, simplifying access to training, and collaborating with employers and training providers …

Gov response: ACCEPT Skills England recognises the need to strengthen and expand jobs and skills data across government to enable robust skills needs assessments, particularly at local levels. High-quality data is also essential for delivering the Industrial …

Response Not Attributed

#11 — Gather annual transport manufacturer data on vocational training effectiveness; report findings to DfE, DWP.

Transport Committee

Recommendation: The Department for Transport should on at least an annual basis gather information from British transport manufacturers on how effectively the UK’s vocational training system is delivering a robust pipeline of skills, and report these findings to the Departments for …

Gov response: Through its engagement with industry, Skills England is in continuous dialogue with employers, including those in the transport manufacturing sector, about what they need from the vocational skills system. The Department for Transport will engage …

Position Not Stated

#7 — Collect and publish intersectional data on victims of religiously and racially aggravated hate crimes.

Women and Equalities Committee

Recommendation: The Government should collect and publish data on the religion, ethnicity and sex of victims of both religiously and racially aggravated hate crimes to help policymakers understand the extent of anti-Muslim hate crimes and the role gender plays in such …

Gov response: We recognise the significance of robust data in developing proportionate, effective and evidence-led policy interventions that meaningfully support the communities we serve. The Home Office already collects and publishes a range of information on religious …

Response Not Attributed

#26 —

Public Accounts Committee

Recommendation: 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 …

Gov response: The government disagrees with the Committee’s recommendation. The government and NHS England are working closely with Hospice UK, Marie Curie, Sue Ryder and Together for Short Lives to ensure the views of hospices are gathered …

Accepted

#24 —

Public Accounts Committee

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 …

Gov response: 5.5 The government disagrees with the Committee’s recommendation: 5.6 It is not for the government to make individual plans for each independent hospice. The government and NHS England will consider contracting and commissioning arrangements, including …

Not Accepted

#23 —

Public Accounts Committee

Recommendation: 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 …

Gov response: 5.1 The government agrees with the Committee’s recommendation: Target implementation date: Autumn 2026 5.2 Earlier this year, NHS England wrote to all ICBs requesting an update on the financial stability of hospices in their footprint, …

Accepted

#21 —

Public Accounts Committee

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 …

Gov response: The government agrees with the Committee’s recommendation. Target implementation date: Autumn 2026. The government is determined to shift more healthcare out of hospitals and into the community, to ensure patients and their families receive personalised …

Accepted

#20 —

Public Accounts Committee

Recommendation: 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 …

Gov response: 4.1 The government agrees with the Committee’s recommendation. Target implementation date: Autumn 2026 4.2 The government is determined to shift more healthcare out of hospitals and into the community, to ensure patients and their families …

Accepted

#16 —

Public Accounts Committee

Recommendation: 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 …

Gov response: 3.1 The government agrees with the Committee’s recommendation. Target implementation date: Autumn 2026 3.2 Last year, NHS England published a Strategic Commissioning Framework, supporting ICBs to respond effectively to current and future needs of their …

Accepted

#15 —

Public Accounts Committee

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 …

Gov response: 1.5 The government agrees with Committee’s recommendation. Target implementation date: Autumn 2026 1.6 ICBs should apply this to all providers, not just hospices, as per the Strategic Commissioning Framework. 1.7 The planned publication of Autumn …

Accepted

#13 —

Public Accounts Committee

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 …

Gov response: 2.1 The government disagrees with the Committee’s recommendation. 2.2 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 …

Not Accepted

#10 —

Public Accounts Committee

Recommendation: 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 …

Gov response: 3.1 The government agrees with the Committee’s recommendation. Target implementation date: Autumn 2026 3.2 Last year, NHS England published a Strategic Commissioning Framework, supporting ICBs to respond effectively to current and future needs of their …

Accepted

#6 —

Public Accounts Committee

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 …

Gov response: The government disagrees with the Committee’s recommendation. The government and NHS England are working closely with Hospice UK, Marie Curie, Sue Ryder and Together for Short Lives to ensure the views of hospices are gathered …

Not Accepted

#3 —

Public Accounts Committee

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 …

Gov response: The government agrees with the Committee’s recommendation. ICBs to respond effectively to current and future needs of their population, in line with the wider expectation of the Model ICB Blueprint. More specifically, NHS England has …

Accepted

#21 —

Health and Social Care Committee

Recommendation: 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 …

Gov response: Accept The Government recognises the vital role that hospices play, alongside NHS services, in supporting people at the end of life. Through recent investment and wider reforms, we are taking steps to support both service …

Response Not Attributed

#13 —

Health and Social Care Committee

Recommendation: 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 …

Gov response: Accept Integrated palliative care and end-of-life care services are central to the shift towards community-based care. They enable care to be delivered closer to people’s homes. NHS England’s statutory guidance for palliative care and end-of-life …

Response Not Attributed

#8 —

Health and Social Care Committee

Recommendation: 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 …

Gov response: Reject Collaboration between ICBs and local authorities (LAs) is a core part of our future operating model as set out in our 10 Year Health Plan. However, the current system where LA and ICB collaboration …

Position Not Stated

#4 —

Health and Social Care Committee

Recommendation: 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. …

Gov response: Accept Accountability arrangements will be critical to ensuring all Modern Service Frameworks drive meaningful and sustained improvement. NHS England and DHSC recognise this as essential to effective implementation and will be working closely as the …

Position Not Stated

#3 —

Health and Social Care Committee

Recommendation: 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 …

Gov response: Accept Accountability arrangements will be critical to ensuring all Modern Service Frameworks drive meaningful and sustained improvement. NHS England and DHSC recognise this as essential to effective implementation and will be working closely as the …

Response Not Attributed

#2 —

Health and Social Care Committee

Recommendation: 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 …

Gov response: Accept Accountability arrangements will be critical to ensuring all Modern Service Frameworks drive meaningful and sustained improvement. NHS England and DHSC recognise this as essential to effective implementation and will be working closely as the …

Response Not Attributed

#51 — Care leavers face significant challenges transitioning into further education, employment or training.

Education Committee

Recommendation: Care leavers face significant challenges transitioning into further education, employment or training. Care leavers aged 19–21 are three times more likely not to be in education, employment or training than their peers. There is insufficient support for those transitioning into …

Gov response: PLANS ALREADY IN PLACE The Get Britain Working White Paper announced the Youth Guarantee for 18–21-year-olds in England to ensure young people are either learning and earning. This includes access to high-quality training, apprenticeships, and …

Accepted

#14 — Develop an evidence-led plan to increase diversity within the transport manufacturing sector.

Transport Committee

Recommendation: Skills England should by the end of 2026 set out an evidence-led plan, commissioning research necessary to fill gaps in knowledge on what has worked best in the manufacturing sector, detailing how it will support the Government’s target to increase …

Gov response: The Government is committed to breaking down barriers to opportunity by building skills for opportunity and growth so that every young person can follow the path that is right for them. DfT is delivering against …

Position Not Stated

#23 — Home Office monitors police efficiency program progress, while College seeks measurement consistency.

Public Accounts Committee

Recommendation: We asked whether the Home Office had the data needed to monitor progress towards its planned savings of £354 million by 2028–29.58 The Home Office said it is important to get the right data to hold police 51 Qq 75-77, …

Gov response: 4.1 The government agrees with the Committee’s recommendation. Recommendation implemented 4.2 The Police Efficiency and Collaboration Programme (PECP) has an annual cashable efficiencies target of £354 million by 2028-29 and a non-cashable efficiencies target of …

Response Pending