Committee publication · Engagement document · 5 September 2025
Palliative Care Breakout room 1 summary note 2603
From: Health and Social Care Committee
Inquiry: Palliative Care
Summary
This is a summary note from a roundtable discussion held on 26 March 2025 with clinicians and service providers for the Health and Social Care Committee's Independent Expert Panel Palliative Care Inquiry. It documents stakeholder views on four focus areas: commissioning of palliative and end-of-life care (PEoLC), delivery of services, shift to community care, and workforce education. Participants identified systemic gaps in funding, data integration, equity of access, community engagement, and workforce capacity.
Key findings
- ICB funding for palliative care is unsustainable and inequitably distributed between adult and children's services; 50% budget cuts prevent implementation of improvements even where need is understood.
- Data integration failures prevent understanding of true population need and patient journeys; rigid data rules obstruct linking datasets across the system, undermining commissioning decisions.
- Underserved populations include perinatal and transition-age children, South Asian and Pakistani communities, individuals with autism and learning disabilities, LGBTQ+ communities, and those living in poverty; intersectionality compounds barriers to access.
- Community shift lacks sufficient workforce capacity (e.g., one county with one–two community nurses for entire population); insufficient consultation with frontline clinicians on implementation feasibility.
- Workforce morale is declining in acute and primary care due to funding pressures, lack of training funding, and concerns around assisted dying implementation; specialist palliative care workforce lacks diversity.
Tone
FactualTopics
Key actors
Health and Social Care Committee Independent Expert Panel, Integrated Care Boards (ICBs), Ambulance services, Hospices (children's and adult), General Practice, NHS England, Specialist palliative care services
Notable line
“The ICB funding model for PEoLC is not sustainable and does not work.”
Key Quotes
“The ICB funding model for PEoLC is not sustainable and does not work. There is an inequity of funding between adults and children's hospices.”
“"We find, as ambulance services, that we see the results of those gaps in commissioning." "Palliative and end of life care is a non-commissioned workload for the ambulance service and yet the cohort of patients that we're seeing is increasing quite a significant rate" …”
“I don't think we have enough public health involvement in segmenting and articulating the population who have a need, to be able to meet those needs adequately.”
“"I think they would welcome guidance, but only if it came with a budget".”
“I'm not sure that people actually have a choice- they go with the services. And so sometimes I think we can put a lot of focus on trying to offer a choice which isn't real.”
“The biggest barrier to training for PEoLC for paramedics is the mindset shift; "I can train a paramedic to do any number of skills …”
“"even if we were to put all the money that we needed into the consultant workforce, there is another truism-that that trainees don't go to places where they don't train. So because we don't have trainees in rural or coastal places, when people qualify as a consultant, they hold out for consultant jobs around big urban centres.”
“"there are some really significant workforce issues in delivering the offer, and I don't really know that they've been properly discussed yet. That will have an influence on recruitment.”
Source · parliament.uk record ↗