Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps he is taking to ensure the (a) sustainable funding and (b) fair commissioning of (i) hospice and (ii) palliative care services take into account the higher cost of delivering services in rural areas.

Palliative care services are included in the list of services an integrated care board (ICB) must commission. To support ICBs in this duty, NHS England has published statutory guidance and service specifications. The statutory guidance states that ICBs must work to ensure that there is sufficient provision of care services to meet the needs of their local populations, which can include hospice services available within the ICB catchment. The statutory guidance also outlines areas for consideration when commissioning, including improving equity of access and reducing inequity in outcomes and experiences.

Whilst the majority of palliative and end of life care is provided by National Health Service staff and services, we recognise the vital part that voluntary sector organisations, including hospices, also play in providing support to people at the end of life and their loved ones.

Most hospices are charitable, independent organisations which receive some statutory funding for providing NHS services. The amount of funding each charitable hospice receives varies both within and between ICB areas. This will vary depending on demand in that ICB area but will also be dependent on the totality and type of palliative and end of life care provision from both NHS and non-NHS services, including charitable hospices, within each ICB area.

The Government and the NHS will closely monitor the shift towards the strategic commissioning of palliative and end of life care services to ensure that the future state of services reduces variation in access and quality, although some variation may be appropriate to reflect both innovation and the needs of local populations.

The Department is currently exploring how to improve the access, quality, and sustainability of all-age palliative and end of life care in line with the 10-Year Health Plan. Officials will present further proposals to ministers over the coming months, outlining how to operationalise the required shifts in palliative care and end of life care to enable the shift from hospital to community, including as part of neighbourhood health teams.