Hospices: Finance
The question
To ask the Secretary of State for Health and Social Care, how sustainable contracting as referred to in the Modern Service Framework for Palliative Care and End-of-Life Care: interim update on 4th June 2026, will be defined and funded in practice.
Answered by Stephen Kinnock
The Modern Service Framework (MSF) will embed palliative care and end-of-life care within a strategic commissioning model that is centred on clear and transparent contractual arrangements for commissioned palliative care activity across all providers, including hospices, to meet population health needs, with explicit regard to reducing inequalities and improving outcomes for underserved and disadvantaged groups.
As part of the interim update, NHS England’s National Director for Primary Care and Community Services has written to systems, setting out two actions to ensure progress is made towards the strategic commissioning of palliative care and end-of-life care services. NHS England’s letter is available at the following link:
Sustainable contracting, as referenced in the MSF interim update, refers to a move away from short-term grant funding towards more strategic, longer-term commissioning arrangements for hospice services. This allows systems to plan, purchase, monitor, and evaluate services over the longer term and, with this, improve population health and reduce health inequalities.
This will involve integrated care boards (ICBs) establishing clear and transparent contractual arrangements for commissioned hospice activity. This approach is intended to support the long-term sustainability of the sector by enabling providers to plan ahead. Decisions on funding and service design will continue to be made locally by ICBs, in line with their statutory responsibilities to commission palliative care services. As set out in the interim update, we expect all ICBs to complete an integrated needs assessment, to gain a detailed understanding of their current and future population, including people of all ages with palliative care and end-of-life care needs. This is vital in order to commission the services to best meet that need, whilst providing the best value for money.
The Government recognises the vital role that hospices play in providing high-quality palliative care and end-of-life care. Most hospices are charitable, independent organisations which receive some statutory funding for providing core National Health Services. Therefore, they are responsible for setting their own pay and employment terms within their financial models, including decisions on adopting Agenda for Change terms and conditions.
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