Palliative Care

Status / emerging findings

• Only 50% of people in their final year of life are on the palliative care register; government has set a stretch target of 90% by 2029, exposing a 30-40 percentage point gap in identification.
• Specialist palliative care workforce described as in 'critical situation' with declining numbers; children's palliative care services particularly undersupplied.
• Commissioning is fragmented: Integrated Care Boards (ICBs) have variable priorities, creating a 'postcode lottery' where access depends on geography rather than need.
• Government announced £25m additional capital funding for hospices (totalling £125m) and £80m revenue funding for children's hospices over three years, but inquiry suggests misdirection of existing £22bn annual spend rather than shortage of total funding.
• Modern Service Framework to be published autumn 2026; government conceded current strategic commissioning capability in ICBs is inadequate and structural accountability mechanisms are missing.

Why it matters

As Parliament debates assisted dying legislation, this inquiry reveals that England cannot yet guarantee dignified end-of-life care for most dying people—meaning the system lacks the baseline palliative care infrastructure that legislators assumed existed.

Tone arc

Inquiry shifted from procedural assessment (autumn 2025 expert panel evaluation) to urgent demand for accountability. By January 2026 evidence session, committee pressed minister on delivery mechanisms, exposing gap between framework commitments and ground-level fragmentation. Government moved from defensive to acknowledging 'fundamental structural issues' requiring step-change by 2029.

Key witnesses

Stephen Kinnock (Minister of State for Care), NHS England officials (Modern Service Framework leads), Department of Health and Social Care representatives, Independent Expert Panel (composition not fully named in documents), Integrated Care Boards (ICBs) - as institutional witnesses