The Independent Expert Panel (IEP), commissioned by the Health
and Social Care Committee, has produced a report on England's
palliative and end of life care services.
Published 28 November, the report [see document attached] follows
an evaluation of palliative care services which began in March
2025.
The evaluation was carried out under five broad headings. The
IEP's findings are summarised below.
Commissioning of palliative and end of life care
services
The IEP found that efforts to commission services are impacted by
complexities and variabilities, leading to differences in quality
around the country. This variability also arises from a lack of a
nation-wide framework for how Integrated Care Boards (ICBs)
should commission palliative care services.
ICBs were often found to not be equipped well enough to
understand the palliative and end of life care needs of their
local populations, in some cases due a lack of access to
data.
Because palliative care is often not prioritised in local areas,
it faces insufficient funding from ICBs, which themselves face
persistent funding pressures.
Delivery of palliative and end of life care
services
The IEP found evidence of services under significant strain
across all types of setting that it examined. It also found some
examples of good practice, such as effective partnerships between
hospices and GPs.
The experts heard that patients and their next of kin struggle to
navigate a complex and fragmented system for palliative and end
of life care. The system lacks a single point of access and
communication.
Service users are also rarely given the opportunity to plan ahead
effectively. Patients were too often not identified early enough
and offered advice, and when conversations did take place they
were not sufficiently meaningful. The Panel also identified that
some patients and families struggle to engage with advance
planning discussions and the prospect of dying.
Furthermore, bereavement services were found to be valuable but
frequently inaccessible due to patchy levels of provision across
the country and a high dependence on voluntary
organisations.
Shifting to the Community
Following the Covid pandemic there has been an increase in the
number of people dying at home, in care homes and in hospices,
while fewer are dying in hospital. Currently just over one
quarter of patients die at home.
The Government's overarching strategy for the NHS, for more
services to be delivered in neighbourhood or community settings
rather than in hospitals, applies strongly to palliative and end
of life care.
However, progress with undertaking this shift has been hindered
due to current funding approaches and inadequacies in local
social care services. Spending on primary and community health
care accounts for 11% of health expenditure for people in their
last year of life, while hospitals receive 81% of the spending.
Moreover, 22% of public expenditure per person at the end of life
is on social care, compared to over 50% of total expenditure on
healthcare.
Workforce, education and skills
The NHS workforce was found to be ill-equipped to meet the needs
of people at the end of life because of insufficient provision of
education and training.
Furthermore, there are shortages of staff in the specialist
palliative workforce, as well as additional shortages in the
generalist workforce, such as district nurses.
Children and young people's palliative and end of life services,
as well as social care services, are also facing serious
shortages of trained professionals.
Inequalities and inequities
The IEP received evidence of systemic inequality throughout the
country, both in terms of the quality of services available in
different parts of the country, but also inequalities experienced
by underserved or marginalised communities.
The IEP report was produced before the Government announced
on 24 November that it intends to develop a Palliative Care and
End of Life Care Modern Service Framework for England, with a
planned publication date of Spring 2026.
The Health and Social Care Committee plans to hold an evidence
session in the New Year with the Minister for Social Care, , to discuss the findings of
the IEP's report.
ENDS
Note to editors
- The Independent Expert Panel (IEP) is a panel of experts
commissioned by the Health and Social Care Committee to carry out
inquiries and produce reports. In this case the IEP was
commissioned to evaluate the quality of palliative care services
in England.
What is the Health and Social Care
Committee?
It is a cross-party group of MPs who scrutinise the spending,
policies and administration of the Department of Health and
Social Care as well as its arm's length bodies and organisations
within the NHS. It is not a government committee but a select
committee of the House of Commons with a key role in holding
ministers to account. Any of our inquiries would correctly be
described as a “parliamentary inquiry” or “an inquiry by
MPs”.
