1st Special Report - Palliative Care: Government Response

Key findings

• Government accepts accountability arrangements for the Modern Service Framework with performance metrics, including 2029 aims to increase identification of people approaching end of life by 10% and reduce non-elective admissions by 10%.
• Accepts inclusion of specific standards for babies, children and young people's palliative care in the MSF, with refreshed statutory guidance and service specifications due later in 2026.
• Accepts 24/7 access guidelines already exist in NHS England statutory guidance; will refresh guidance and coordinate with community pharmacy and out-of-hours services.
• Rejects removing local authority representation from ICBs, arguing the current system is confusing; proposes collaboration at 'place' level through health and wellbeing boards under neighbourhood health model.
• Rejects 90% Palliative Care Register target but acknowledges 75%-90% of those dying in each year could be identified, setting this as a stretch target for 2029.
• Accepts mandate for fully populated palliative care dashboards; ICBs expected to use comprehensive utilisation and cost data from April 2026.
• Accepts Single Patient Record will extend to social care, voluntary, and private providers over time, with patient access via NHS App from 2028.
• Partially accepts workforce recommendations; commits to training through e-ELCA programme and developing Qualification in Specialism modules ready by March 2027/28, but declines to mandate specific competencies or staffing targets.
• Accepts ICBs must be held accountable for bereavement services through existing NHS Oversight Framework; no additional monitoring plans beyond current arrangements.
• Accepts sustainable hospice funding through strategic commissioning approach; ICBs to move away from short-term grants to sustainable contracting from 2027/28.

Government position

The Government accepts 8 of 10 recommendations. It rejects the recommendation to retain local authority representation on ICBs, citing the need to simplify collaboration structures and reflect ICBs' core role as strategic commissioners; it argues future collaboration will occur at 'place' level through health and wellbeing boards. It also rejects the 90% Palliative Care Register target, though acknowledges a 75%-90% stretch target for 2029. The Government partially accepts workforce recommendations, declining to mandate specific competencies or staffing targets but committing to training programmes and Qualification in Specialism modules. Overall stance: accepts recommendations broadly aligned with the Modern Service Framework implementation and existing accountability structures; rejects those requiring structural reorganisation or prescriptive targets.

Key actors

Health and Social Care Committee, Department of Health and Social Care (DHSC), NHS England, Integrated Care Boards (ICBs), National Quality Board, National Bereavement Alliance, Baroness Casey, Layla Moran