Ageing and End-of-life Care

Julie Minns Excerpts

Thursday 30th October 2025 Commons Chamber

[Jim Shannon]

The hon. Member is absolutely right. Politics aside, I want the Minister and the Government to do the job. It does not matter who the politician or the political party is; let us just give our people some hope. That is what I wish to see come out of this.

What assessment have the Government made of the need for a national strategy for palliative and end-of-life care? How will the Government ensure that palliative care specialists are included in neighbourhood health centres? What progress are the Government making on ensuring that every person with palliative care needs in the UK has access to a 24/7 support and advice line?

I believe that we can find a route towards an acceptable standard of life not simply for those who can afford private healthcare, but for all in our ageing communities. I understand that the Minister has a copy of my notes, and my seven points will be in there. To realise the 10-year plan objectives, which I have clearly said I support and want to see happen as soon as possible, palliative and end-of-life care must be recognised as a vital part of our health and social care system. Without making palliative and end-of-life care a priority for health reform, the Government will not achieve their bold ambition to provide more care in the community. I want the Government to achieve that ambition.

[Ms Julie Minns (Carlisle) (Lab)]

I spoke earlier to the hon. Gentleman to ask if he would take an intervention. When earlier this year my mum was placed on end-of-life care—she was put into the local hospital to receive that care—I had to repeatedly ask hospital staff to transfer her to our local, excellent Eden Valley hospice. It took three days for that request to be actioned. Does the hon. Gentleman agree that one change we could make is that, when someone in our hospitals is placed on end-of-life care, their families could be immediately apprised of the alternative provision that exists in our communities?

[Jim Shannon]

The hon. Lady is absolutely right—by the way, that is one of my seven points. We have spoken, but not exactly about that. The debate brings us together with our requests for the Minister and the Government; we are thankful for that.

Only 38% of those who died aged 85 or older received care from palliative care specialists, compared with 51.5% of those aged 65 to 84 and 59.3% of those aged 18 to 64. To the point made by the right hon. Member for New Forest East, most aged 18 to 64 spent most of their final months in a private home, but fewer than 50% of those aged 65 or older did so. One in seven people—15%—who died in hospital had been in there for less than 24 hours. When someone is coming to their last days, many complex needs are involved—there are also the problems for the family—but they will have to deal with two things in particular: pain, and probably breathlessness.

Almost two thirds of unpaid carers felt anxious most or all the time about the dying person’s illness or treatment. Shifting care from the hospital to the community would benefit older people, support the shift from hospital to community—analogue to digital—and prevent avoidable emergency care admissions. Those are all things that the Government must develop in a national strategy for palliative and end-of-life care.

The strategy must deliver on these seven points. First, an integrated whole-system approach is needed enabling patients at the end of life to move seamlessly through services as their health changes. Secondly, the Government must place palliative care at the centre of plans for neighbourhood health centres and ensure the inclusion of palliative care specialists. A key benefit of including palliative and end-of-life care in neighbourhood health centres will be the earlier identification of palliative care need and greater uptake of advance care planning.

Thirdly, the Government implement models of emergency and urgent care that can minimise avoidable accident and emergency visits. That would provide financial savings for the NHS as well as giving better care in a better system. That also comes to the input of the families, which is the very thing we all wish to see.

Fourthly, the Government need to strengthen the statutory guidance on the legal duty to commission palliative care services in the Health and Care Act 2022. Holding integrated care boards to account for the delivery of this duty must be part of that. Fifthly, we must introduce national quality standards for palliative and end-of-life care that must be met in all health and care settings. That would strengthen accountability while catalysing the 10-year health plan’s targeted shift from hospital to community for patients at the end of life. They must also support more equitable implementation of the vision set out in the ambitious national framework for local action.

Sixthly, there must be access to 24/7 support—the very thing being asked for—by creating a universal gateway to 24/7 specialist palliative and end-of-life care advice, guidance and support through NHS 111. In my constituency, we would say “yin, yin, yin.”

Seventhly, there must be a long-term, sustainable funding solution for palliative and end-of-life care that can reduce reliance on charitable fundraising and ensure parity of esteem for the NHS and non-NHS palliative care workforce. A transformation fund must also be created to invest in innovative and integrated models of care to meet different community needs. The Minister is probably saying, “My goodness, is it just seven points?”, but yes, I will stop at those seven, although I would like to comment on Sue Ryder if I may.

All of these stats can become figures on a page, but when I read them I think of the wee mummy lying on her bathroom floor after a fall, all night in tears; I think of my constituents who sob in my office, begging for help with their dying parent; I think of carers who are run ragged and know that a 15-minute call with that elderly person cannot possibly cater to their hygiene needs as well as feeding them; I think of district nurses who are late home because they would not leave their elderly patient upset after a wound change, and who made them a wee cup of tea and stayed for that comforting chat that time had not been allocated for.

Professor Jugdeep Dhesi, president of the British Geriatrics Society, said:

“Everyone should have access to high quality care until the end of their life, including palliative and end of life care when they need it. Sadly, this is not the case for many older people across the United Kingdom.”

Sue Ryder also asked me to highlight some issues. It is working to create a new ecosystem around palliative and end-of-life care, and to unlock hospital productivity through swiftly shifting care to the community in a progressive way that is sensitive to the resources available across the wider system, and focused on genuine collaboration at a local, place, and system level. The envisaged ecosystem would absorb patients from across the acute setting and increase referrals to community settings, helping our wonderful NHS to use its bed capacity more effectively, and relieving strain on the discharge system. The Sue Ryder model will shift care into the community by increasing hospice-at-home services and virtual wards, funded in line with national currencies and fast-track CHC reform. It is believed that this new approach to hospital care will develop dedicated care, alongside suites on NHS sites to provide compassionate, tailored care for those approaching the end of life, and to relieve pressure on hospital teams.

We must increase support for people in their own homes—that is what I want, what the hon. Member for Carlisle (Ms Minns) wants, and probably what we are all seeking. It is about expanding care in the community through partnerships, virtual wards, and increased hospice-at-home services to help more people die at home and reduce emergency admissions. We must aim to make full use of hospices’ expertise and space to support people with complex multi-morbidities and those in the last 1,000 days of life, preventing emergency admissions and helping people to live well.

I will keep to your timescale, Madam Deputy Speaker; I am coming to the end. The end of life is not a happy topic, but I believe it is a necessary conversation. We must open that conversation to ensure that people feel able to record their wishes for the end of life, so that more of their needs are met by the people involved in their care. We must ensure that there is information, and above all funding to deal with the growing pressure—the family issue that the hon. Member for Carlisle referred to—because how we treat the most vulnerable in our society is the measure that we will all be judged by.

I am no better than anybody else, but as elected representatives you and I, Madam Deputy Speaker, and everyone in the Chamber want to do the best for our people. Today we ask for the best for our people. I work alongside my mum to ensure that her last time on earth is the best we can make it, and I know I can safely say that it is the desire of this House and the Minister to provide that for every person in the United Kingdom of Great Britain and Northern Ireland. But we cannot do it without Government buy-in, or without help from the Minister, and from the Labour Government and those in power. The hospice sector is looking for a way to do things better, so I ask the Minister to join those who know this issue inside out, and find a route to help our ageing community and those in end-of-life care. That is also from Marie Curie, Sue Ryder and Professor Dhesi—all those people, and all of us as MPs on behalf our constituents.

Thank you for your time, Minister, and I look forward to your response.