Committee publication · Correspondence · 26 January 2026
Letter from the Chief Executive Officer of NHS England relating to the Committee’s evidence session on 12 January 2026 on Financial Sustainability of Adult Hospices, 16 January 2026
From: Public Accounts Committee
Inquiry: Financial sustainability of adult hospices in England
Summary
NHS England's CEO responds to the Public Accounts Committee's evidence session on hospice financial sustainability (12 January 2026). The letter outlines immediate actions taken since July 2024—including £100m capital funding and £80m revenue funding for children's hospices—and describes longer-term reform through a Modern Service Framework (MSF) to address fragmented commissioning, poor data, and unequal access. NHS England has commissioned an urgent survey of hospice financial stability and plans to move away from grants towards transparent contractual arrangements.
Key findings
- Around 60% of people who died in 2023 had at least one emergency admission in final three months; 6.2% experienced three or more emergency admissions, indicating care is occurring in wrong settings
- Government has allocated £100m capital funding (£25m spent 2024/25, £75m for 2025/26) plus further £25m confirmed for 2025/26; £80m revenue funding allocated for children's and young people's hospices over 2026/27–2028/29
- NHS England issued urgent directive on 11 January to all Integrated Care Boards (ICBs) requesting immediate position statements on hospice financial stability and closure risks
- Palliative Care and End-of-Life Care MSF is one of only five announced Modern Service Frameworks; full publication planned Autumn 2026 with ICB implementation from remainder of 2026/27 onwards
- Current hospice provision is geographically skewed towards urban and wealthier areas; only 5.5% of deaths occur in hospices versus 42.3% in hospitals, 28.1% at home, and 21.5% in care homes
Tone
ProceduralTopics
Key actors
Sir James Mackey, Chief Executive, NHS England, Sir Geoffrey Clifton-Brown, Chair, Public Accounts Committee, Dr Amanda Doyle, Minister of State for Care, Dr Sarah Mitchell, Dr Edward Scully, Hospice UK, Together for Short Lives, Sue Ryder, Marie Curie
Notable line
“Reform, therefore, is not optional. 2 Too much care is happening in the wrong place and too late.”
Key Quotes
“Hospices are a core part of the health service, not a "nice to have." For many people …”
“We estimate that c.£12 billion is spent by the NHS alone on end-of-life care. This is a very large sum of taxpayers' money, and so it is right that we look at whether this is being spent in a way that delivers the best possible value and outcomes.”
“Following our discussion at Monday's hearing, we agree that a more robust understanding of hospice financial fragility is required. On Tuesday, Dr Amanda Doyle wrote to all ICBs requesting an immediate, up-to-date position statement on the financial stability of hospices within their footprint, and the steps being taken to mitigate risks as a matter of urgency.”
“Our ambition is a system in which people receive consistent, high-quality palliative care and end-of-life care in the setting that is right for them — whether hospice, home, hospital, or care home.”
“Poor data has undermined commissioning and national oversight. In the Medium-Term Planning Framework , we made clear that, from April 2026, ICBs will be expected to understand current and future utilisation and costs for palliative care and end-of-life care, irrespective of provider.”
Source · parliament.uk record ↗