Committee publication · Engagement document · 5 September 2025

Palliative Care Lived experience roundtable breakout room 1 summary note 2304

From: Health and Social Care Committee

Inquiry: Palliative Care

Summary

Summary note from a Health and Social Care Committee roundtable held 23 April 2025 with palliative and end-of-life care (PEoLC) lived experience contributors—patients, families, carers, healthcare professionals, and charity workers. Participants identified widespread disparities in care quality between specialist hospices (73% satisfaction) and generalist hospital services (43% satisfaction), postcode lottery access, poor service integration, lack of dedicated clinical support, insufficient training for generalist staff, and insufficient social care capacity to enable community-based care shifts.

Key findings

  • Specialist hospice care delivers significantly better outcomes (73% satisfaction) than generalist hospital provision (43%), with geographic access highly variable based on location; majority of people dying never access hospice care.
  • Generalist services lack understanding of palliative care definitions and appropriate clinical conversations; clinicians sometimes provide inaccurate information, deterring families from palliative approaches.
  • Poor integration and communication between services causes duplication, delays, and distress; only 42% of surveyed individuals felt care was well-coordinated; information-sharing failures lead to harmful incidents.
  • Families forced to advocate intensively for loved ones' care; system navigation particularly difficult for those without prior experience, non-English speakers, or ethnic minorities facing cultural mistrust of health services.
  • Concerns about shifting care to community without adequate social care capacity, funding, training, and support for unpaid carers; building blocks including specialist family support and respite care largely absent.
  • Lack of dedicated clinical persons to guide individuals through end-of-life journey; absence of Admiral nurses in many areas leaves families without specialist support; advance care planning conversations poorly timed and incompletely communicated.

Tone

Factual

Topics

palliative-careend-of-life-carehealthcare-equitysocial-careservice-integration

Key actors

Health and Social Care Committee, Independent Expert Panel (Palliative Care Inquiry), Lived experience roundtable participants (patients, families, carers, healthcare professionals, charity workers), Hospices, District nurses, GPs, Social care services, Admiral nurses

Notable line

"the majority of people who die never even see the front door of a Hospice".

Key Quotes

73% of people said they were happy with Hospice care, but only 43% were happy with the hospital care they received at the end of life
Participant (organisation survey) · describing disparity between specialist and generalist provision
… often I see patients and I ask where they live. I breathe a sigh of relief, or I'm disappointed.
District nurse participant · on geographic variability of hospice access across two counties
"if we go palliative, we're going to stop everything. We won't need any more medications, we'll just stop everything …
Doctor (quoted by participant) · example of inaccurate clinical communication about palliative care
Everything that we didn't want to happen and nobody could help us.
Participant (dementia mother's case) · describing inability to find local care for mother with complex dementia needs
In my head everyone should be able to get good palliative and end of life care from generalist services, they shouldn't have to get it from specialist services.
Roundtable participant (quoted on generalist services) · advocating for strengthened generalist provision as solution to postcode lottery
"It wasn't that he didn't want the help, it's that he didn't trust where the help was coming from. People needed to build up time to have a relationship with him, but he was never given that time.
Participant (ethnic minority background) · describing cultural mistrust and communication barriers for ethnic minority elders
It wasn't until mum moved into the care home and when one of the nurses sat with me and explained the process of dying. They just made me feel like I could be a daughter again.
Participant (dementia mother's care) · describing impact of dedicated clinical support in reducing family burden
… only around 50% of the carers that we spoke to felt they were supported well enough while their relative was alive. And that fell to less than 50% when we were talking about support after a loved one or relative had died.
Participant (carer support survey) · on inadequacy of carer and bereavement support
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Source · parliament.uk record ↗