Asked by: Neil Hudson (Conservative - Penrith and The Border)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what recent steps her Department has taken to support hospices.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
As part of the Health and Care Act 2022, the Government added palliative care services to the list of services an integrated care board (ICB) must commission, which will ensure a more consistent national approach and support commissioners in prioritising palliative and end of life care, including from hospices.
The majority of palliative and end of life care is provided by NHS staff and services. However, we also recognise the vital part that voluntary sector organisations, including hospices, play in providing support to people at end of life and their families. Most hospices are charitable, independent organisations which receive some statutory funding for providing services within the National Health Service. The amount of funding hospices receive is dependent on many factors, including what other statutory services are available within the ICB footprint. Charitable hospices provide a range of services which go beyond that which statutory services are legally required to provide. Consequently, the funding arrangements reflect this.
At a national level, NHS England supports children’s hospices through the Children and Young People’s hospice grant. It has confirmed that it will be renewing the grant for 2024/25, once again allocating £25 million of grant funding for children’s hospices using the same prevalence-based allocation approach as in 2022/23 and 2023/24.
The Government has provided additional funding to help deliver the one-off payments to eligible staff employed by non-NHS organisations, which employ their staff on dynamically linked Agenda for Change contracts. Organisations, such as hospices, were able to apply for the funding if they were able to show they had been negatively financially impacted by the pay deal, and that their staff are employed on dynamically linked Agenda for Change contracts.
Asked by: Bill Wiggin (Conservative - North Herefordshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if she will make an assessment of the potential implications for her policies of the report by the APPG for Hospice and End of Life Care entitled Government funding for hospices, to be published in February 2024.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
The Department is already taking actions which will address many of the recommendations of the All-Party Parliamentary Group’s report. As part of the Health and Care Act 2022, the Government added palliative care services to the list of services an integrated care board (ICB) must commission, which will ensure a more consistent national approach and support commissioners in prioritising palliative and end of life care.
The majority of palliative and end of life care is provided by National Health Service staff and services. However, we also recognise the vital part that voluntary sector organisations, including hospices, play in providing support to people at end of life and their families. Most hospices are charitable, independent organisations which receive some statutory funding for providing NHS services. The amount of funding hospices receive is dependent on many factors, including what other statutory services are available within the ICB footprint. Charitable hospices provide a range of services which go beyond that which statutory services are legally required to provide, and consequently, the funding arrangements reflect this.
NHS England has commissioned the development of a palliative and end of life care dashboard, which brings together all relevant local data in one place. The dashboard helps commissioners understand the palliative and end of life care needs of their local population, enabling ICBs to put plans in place to address and track the improvement of health inequalities and ensure that funding is distributed fairly based on prevalence.
In July 2022, NHS England published statutory guidance and service specifications for commissioners on palliative and end of life care, setting out the considerations for ICBs to meet their legal duties. The guidance makes specific reference to commissioners defining how their services will meet population needs 24 hours a day, seven days a week.
The Government have also provided additional funding to help deliver the one-off payments to eligible staff employed by non-NHS organisations, who employ their staff on dynamically linked Agenda for Change contracts. Organisations were able to apply for the funding and needed to show they had been negatively financially impacted by the pay deal, and that their staff are employed on dynamically linked Agenda for Change contracts.
Asked by: Lord Hunt of Kings Heath (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what monitoring arrangements are in place to evaluate the effectiveness or otherwise of integrated care boards in discharging their responsibility for determining the level of locally NHS-funded palliative and end of life care, including hospice care.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department is in ongoing discussions with NHS England about oversight and accountability of palliative and end of life care commissioning in the National Health Service. NHS England has agreed to include palliative and end of life care in the list of topics for its regular performance discussions between national and regional leads. The regional quality and performance meetings will provide an additional mechanism for supporting integrated care boards (ICBs) to continue to improve palliative and end of life care for their local population.
Whilst the detail of the key points for palliative and end of life care are still being discussed, this is likely to include: improved access to care through increased identification of patients likely to be in the last year of life, using the GP Palliative Care Register; improved quality of care, including progression towards around-the-clock access to specialist palliative care advice for staff; and improved experience of care through an improved percentage of patients being offered a personalised care and support plan and advance care plan for those identified. These national meetings will provide an additional mechanism for supporting ICBs to continue to improve palliative and end of life care for their local population.
Asked by: Rachael Maskell (Labour (Co-op) - York Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what recent assessment she has made of the adequacy of her Department's funding of (a) hospices and (b) St Leonard's Hospice in York.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
Integrated care boards (ICBs) are responsible for determining the level of National Health Service funded palliative and end of life care, including hospice care, locally, and are responsible for ensuring that the services they commission meet the needs of their local population. As part of the Health and Care Act 2022, the Government added palliative care services to the list of services an ICB must commission, which will ensure a more consistent national approach and support commissioners in prioritising palliative and end of life care.
The majority of palliative and end of life care is provided by NHS staff and services. However, we also recognise the vital part that voluntary sector organisations, including hospices, play in providing support to people at end of life and their families. Most hospices, including St Leonard’s Hospice, are charitable, independent organisations which receive some statutory funding for providing NHS services. The amount of funding hospices receive is dependent on many factors, including what other statutory services are available within the ICB footprint. Charitable hospices provide a range of services which go beyond that which statutory services are legally required to provide and, consequently, the funding arrangements reflect this.
Asked by: George Howarth (Labour - Knowsley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if she will make an assessment of the implications for her policies of the report by Together for Short Lives entitled The deep disparity in NHS funding for children who need hospice care, published on 13 December 2023.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
The Government recognises that access to high-quality, palliative and end of life care can make all the difference to individuals and their loved ones. The commissioning of children and young people’s palliative and end of life care services is the statutory duty of integrated care boards (ICBs). ICBs must commission palliative and end of life care services in response to the needs of their population, provided by a range of local organisations with the experience and skills to meet those needs.
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 end of life and their families. Most hospices are charitable, independent organisations which receive some statutory funding for providing NHS services. The amount of funding hospices receive is dependent on many factors, including what other statutory services are available within the ICB footprint. Charitable hospices are autonomous organisations that provide a range of services which go beyond that which statutory services are legally required to provide. Consequently, the funding arrangements reflect this.
Due to the way the hospice movement organically grew, hospice locations were largely not planned with geographic or demographic purposes as a driving force. Therefore, there are inequalities with access to hospice services, especially for those living in rural or socio-economically deprived areas. It is therefore vital that hospices and statutory services work together to provide ensure their populations have access to palliative and end of life care when they need it.
At a national level, in line with the NHS Long Term Plan commitment, NHS England (NHSE) has provided circa £12 million match-funding to participating ICBs (and formerly clinical commissioning groups) between 2020/21 and 2023/24 which committed to invest in children and young people’s palliative and end of life care, including children and young people’s hospices, giving a total investment of £24 million. In addition, NHSE supports palliative and end of life care for children and young people through the Children and Young People’s Hospice Grant. NHSE has confirmed that it will be renewing the grant for 2024/25, once again allocating £25 million grant funding for children’s hospices using the same prevalence-based allocation approach as in 2022/23 and 2023/24. This prevalence-based approach ensures funding matches local need.
NHSE’s palliative and end of life care team has recently engaged with 24 ICBs to understand how to better support commissioners and has also reviewed all 42 ICB Joint Forward Plans for their inclusion of palliative and end of life care, with 69% of those plans making a specific mention. Further analysis is ongoing, but the intention is to use this information to help shape and focus support to ICBs.
Palliative and end of life care has been added to the agenda for Regional Quality and Performance meetings. Additionally, NHSE has commissioned the development of a palliative and end of life care dashboard, which brings together all relevant local data in one place. The dashboard helps commissioners understand the palliative and end of life care needs of those their local population, including the ability to filter the available information, such as by deprivation or ethnicity, thereby, enabling ICBs to put plans in place to address and track the improvement of health inequalities.
Asked by: Baroness Hodgson of Abinger (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the prospects of equitable access to hospice care for all children and young people who need palliative and end of life care in 2024.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government recognises that access to high-quality, palliative and end of life care can make all the difference to individuals and their loved ones. Funding for children’s and young people’s palliative and end of life care is made available locally through integrated care boards (ICBs), which are responsible for commissioning services in response to the needs of their local population.
In addition, NHS England has confirmed that it will be renewing the Children and Young People’s hospice grant for 2024/25, once again allocating £25 million grant funding for children’s hospices. NHS England is reprioritising budgets for 2024/25, in light of the revised assessment of financial position and, whilst it is holding funding aside for the children and young people’s hospice sector, it cannot confirm further details, including the distribution mechanism, until 2024/25 financial planning is concluded.
Children and young people’s palliative and end of life care is provided by a range of services and providers from across the statutory and voluntary, community and social enterprise sectors. The majority of palliative and end of life care is provided by National Health Service staff and services, but we recognise that the voluntary sector organisations, including hospices, also play a very vital part in providing support to people at end of life and their loved ones.
The Government has not made a direct assessment of the prospects of equitable access to hospice care for all children and young people who need palliative and end of life care in 2024. However, NHS England’s palliative and end of life care team has recently engaged with 24 ICBs to understand how to better support commissioners and has also reviewed all 42 ICB Joint Forward Plans for their inclusion of palliative and end of life care, with 69% making a specific mention. Further analysis is ongoing, but the intention is to use this to help shape and focus support to ICBs.
Asked by: Baroness Hodgson of Abinger (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how much money was spent per case on palliative and end of life care for children and young people in (1) 2022, and (2) 2023; and how much they anticipate spending in 2024.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government does not hold information on how much money was spent per case on palliative and end of life care for children and young people in 2022 and 2023. Patient-level spend is not collated at a national level, with spend based on need determined during the integrated care board (ICB) commissioning process.
At a national level, NHS England supports palliative and end of life care for children and young people through the Children and Young People’s hospice grant. The grant provided approximately £17 million in 2021/22, £21 million in 2022/23 and £25 million in 2023/24 directly to children and young people’s hospices. NHS England has confirmed that it will be renewing the grant for 2024/25, once again allocating £25 million grant funding for children’s hospices using the same prevalence-based allocation approach as in 2022/23 and 2023/24. NHS England is reprioritising budgets for 2024/25, in light of the revised assessment of financial position and, whilst it is holding funding aside for the children and young people’s hospice sector, it cannot confirm further details, including the distribution mechanism, until 2024/25 financial planning is concluded.
Additionally, in line with the NHS Long Term Plan commitment, NHS England has provided approximately £8.5 million match-funding to participating ICBs and formerly clinical commissioning groups between 2022/23 and 2023/24 that committed to invest in children and young people’s palliative and end of life care, including hospices, giving a total investment of £17 million for that period.
Asked by: Lord Carlile of Berriew (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they expect integrated care boards in England to be able to identify how much money they spend on children’s hospices; and, if not, what action they will take.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government does not hold information regarding the amount of money each integrated care board (ICB) spends on children’s hospices. There is currently no plan to take any action to ensure that ICBs can identify how much money they spend specifically on children’s hospices.
At a national level, NHS England supports palliative and end of life care for children and young people through the Children and Young People’s hospice grant. The grant provided approximately £17 million in 2021/22, £21 million in 2022/23 and £25 million in 2023/24 directly to children and young people’s hospices. NHS England has confirmed that it will be renewing the grant for 2024/25, once again allocating £25 million grant funding for children’s hospices using the same prevalence-based allocation approach as in 2022/23 and 2023/24. NHS England is reprioritising budgets for 2024/25, in light of the revised assessment of financial position and, whilst it is holding funding aside for the children and young people’s hospice sector, it cannot confirm further details, including the distribution mechanism, until 2024/25 financial planning is concluded.
Additionally, in line with the NHS Long Term Plan commitment, NHSE has provided approximately £8.5 million match-funding to participating ICBs and formerly clinical commissioning groups between 2022/23 and 2023/24 that committed to invest in children and young people’s palliative and end of life care, including hospices, giving a total investment of £17 million for that period.
Asked by: Rachael Maskell (Labour (Co-op) - York Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether she (a) is taking and (b) plans to take steps to review the funding model for hospices for (i) children and young people and (ii) adults.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
A review is not currently taking place. Integrated care boards (ICBs) are responsible for determining the level of National Health Service-funded palliative and end of life care, including hospice care, locally, and they are responsible for ensuring that the services they commission meet the needs of their local population.
While the NHS has always been required to commission appropriate palliative and end of life care services to meet the reasonable needs of the population, as part of the Health and Care Act 2022, the Government added palliative care services to the list of services an ICB must commission, to clarify this responsibility.
In June 2023, NHS England confirmed that it would be renewing the Children and Young People’s Hospice Grant for 2024/25, once again allocating £25 million grant funding for children’s hospices in England. NHS England will communicate further details regarding the process for the grant allocations later this year.
Asked by: Rachael Maskell (Labour (Co-op) - York Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps she is taking to ensure there is sufficient capacity within the NHS workforce to provide (a) hospice and (b) at-home hospice services.
Answered by Helen Whately - Minister of State (Department of Health and Social Care)
Integrated care boards (ICBs) are responsible for commissioning palliative and end of life care services, including from the hospice sector, that meet the needs of their local populations. Most hospices are independent charitable organisations that receive some statutory funding from ICBs. Hospices remain free to develop and adapt their own terms and conditions of employment.
The NHS Long Term Workforce Plan (LTWP), published on 30 June 2023, sets out the steps the National Health Service and its partners need to take to deliver an NHS workforce that meets the changing needs of the population over the next 15 years. Commitments in the LTWP to increase the healthcare workforce will benefit a range of providers, including those that deliver palliative and end of life care services.