---

Ageing community and end of life care

Ageing community

The UK’s population is ageing. Data from the Office for Statistics shows that in the year to mid-2024, the number of people aged 65 and over increased by:

• 2.0% in Scotland and Northern Ireland
• 1.8% in England
• 1.5% in Wales

According to data from the Organisation for Economic Co-operation and Development (OECD), there are currently nearly 36 people aged 65 or over for every 100 people aged 20 to 64 in the UK.

Further information on the ageing population in the UK can be found in the Library briefing: The UK’s changing population (July 2024).

End of life care

End of life care in England refers to care given in the last year of life. However, the NHS notes that end of life care should start when a person needs it, and it could last days, months, or can sometimes last over a year.

The NHS webpage on end of life care provides information about what end of life care involves, where end of life care can be accessed, and advice for those planning ahead for end of life care. The webpage says that:

End of life care should help you to live as well as possible until you die and to die with dignity. The people providing your care should ask you about your wishes and preferences and take these into account as they work with you to plan your care.

They should also support your family, carers or other people who are important to you.

End of life care can be provided at home, or in a care home, hospice or hospital, depending on the needs and preferences of the individual. It is provided by a range of health and social care professionals, such as hospital doctors and nurses, GPs, and counsellors. GPs have responsibility for individuals who are being cared for at home or in a care home.

Palliative care

End of life care is a form of palliative care.

There are varying definitions of palliative care. The World Health Organisation defines it as an approach to improve the quality of life of patients and their families who are facing challenges associated with life-limiting illness, usually progressive. Palliative care can prevent and relieve suffering through identifying, assessing and treating pain and other problems whether physical, social or spiritual.

Palliative care is available to an individual from when they first learn they have a life-limiting illness.

One aspect of palliative care is generalist care. This is provided by health care professionals for whom care of the dying is not the major focus of their work, and focusses on day-to-day care and support. As well as this, some people may require additional specialist palliative care, which involves multi-disciplinary teams of specialists co-ordinating and providing care in hospital, hospice and community settings.

Further information can be found in the 2022 briefing on Palliative and End of Life Care by the Parliamentary Office of Science and Technology.

NHS guidance

Section 21 of the Health and Care Act 2022 introduced a statutory requirement for integrated care boards (ICBs) in England to commission services to provide palliative care (alongside other healthcare services) to meet the needs of their local population. ICBs receive a general funding allocation from NHS England to deliver these services.

NHS England has published statutory guidance for ICBs on palliative and end of life care. This guidance points to two existing frameworks to guide palliative care delivery:

• Ambitions for Palliative and End of Life Care: A national framework for local action 2021-2026 (PDF) was developed by a wide range of NHS organisations, professional bodies, charities and patient groups. It sets out a framework for ICBs to evaluate commissioning and delivery of local palliative care services.
• The NHS England Palliative and End of Life Care National Delivery Plan 2022-2025 (PDF) sets out a three-year plan to improve access, quality and sustainability of palliative care.

Commission on Palliative and End of Life Care

At the start of December 2024, it was reported in the press that Rachael Maskell MP would lead a commission on palliative care to help improve end of life care.

The commission’s website outlines its work:

The Commission’s work aims to produce recommendations for solutions to the current difficulties and gaps in access to high-quality palliative care that can meet the extensive range of needs of our diverse population in all areas of the UK. The evidence we receive will be carefully read and analysed, as will evidence heard from witnesses and roundtable meetings. Commissioners are not there to represent their own organisation, but to take a broad overview to find ways forward that can feed into the ten-year plan. 

Following the analysis of research and evidence gathered by the Commission, a report will be written to present to the Secretary of State for Health and Social Care, Members of the Houses of Commons and Lords, and service commissioners, and will be available for providers, clinicians and the public.  

Thus far, the commission has published two volumes of its final report on Palliative Care and End-of-Life Care:

• Opportunities for England, Volume 1 (May 2025). This volume includes recommendations to develop a National Strategy for palliative and end of life care, and to improve access to care, for example by commissioning specialist palliative care more widely and introducing mandatory palliative care training in all undergraduate health and social care programmes. The full list of recommendations can be found on pages 52-61 of volume 1.
• Opportunities for the NHS Ten Year Plan, Volume 2 (June 2025). Volume 2 was published in advance of the 10 Year Health Plan for England. It considered 532 written evidence submissions from a range of groups including clinicians, patients, carers and academics, and highlights the following themes:
  • The need for adequate and sustainable funding
  • Access and equity
  • Workforce and training
  • Care coordination and integration
  • Timely referrals, identification, and conversations

NIHR Policy Research Unit for Palliative and End of Life Care

In January 2024, the National Institute for Health and Care Research (NIHR), which is funded by the Department of Health and Social Care, invested £3 million into a Policy Research Unit for Palliative and End of Life Care.

The NIHR says the policy research unit aims to provide support to policymakers “to improve care and reduce inequalities for people affected by life-limiting illnesses.” It provides research and policy briefings for policymakers, practitioners, service users and community groups, and the government has said it “is building the evidence base on palliative care and end of life care, with a specific focus on inequalities.”

Parliamentary materials

Parliamentary questions

Palliative Care

22 October 2025 | UIN 82575

Asked by: David Chadwick

To ask the Secretary of State for Health and Social Care, if he will take steps to ensure that people living in each region have equal levels of access to palliative care.

Answering member: Stephen Kinnock | Department of Health and Social Care

Palliative care services are included in the list of services an integrated care board (ICB) must commission. ICBs are responsible for the commissioning of palliative care and end of life care services, to meet the needs of their local populations. To support ICBs in this duty, NHS England has published statutory guidance and service specifications.

NHS England has also developed a palliative care and end of life care dashboard, which brings together all relevant local data in one place. The dashboard helps commissioners understand the palliative care 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.

The Department and NHS England are currently looking at how to improve the access, quality, and sustainability of all-age palliative care and end of life care in line with the 10-Year Health Plan.

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

Additionally, through the National Institute for Health and Care Research, the Department is investing £3 million in a new Policy Research Unit in Palliative and End of Life Care. This unit launched in January 2024 and is building the evidence base on palliative care and end of life care, with a specific focus on inequalities.

On ICB accountability, NHS England has a legal duty to annually assess the performance of each ICB in respect of each financial year and to publish a summary of its findings. This assessment must assess how well the ICB has discharged its functions.

Whilst the majority of palliative care and end of life care is provided by National Health Service staff and services, we recognise the vital part that charitable hospices play as well, which is why we are supporting the hospice sector with a £100 million capital funding boost for eligible adult and children’s hospices in England to ensure they have the best physical environment for care.

We are also providing £26 million in revenue funding to support children and young people’s hospices for 2025/26.  I can also now confirm the continuation of this vital funding for the three years of the next Spending Review period, from 2026/27 to 2028/29 inclusive. This funding will see approximately £26 million, adjusted for inflation, allocated to children and young people’s hospices in England each year, via their local ICBs and on behalf of NHS England, as happened in 2024/25 and 2025/26. This amounts to approximately £80 million over the next three years.

Palliative care: Recruitment

12 September 2025 | UIN HL8964

Asked by: Lord Jackson of Peterborough

To ask His Majesty's Government what assessment they have made of the report of the Commission on Palliative and End-of-Life Care Opportunities For England, published in May.

Answering member: Baroness Merron | Department of Health and Social Care

The Minister of State for Care (Stephen Kinnock MP) met the Hon. Member for York Central and Baroness Finlay of Llandaff to discuss the progress of their independent commission into palliative and end of life care, including the commission’s first of three reports, published on 13 May 2025, which he has formally responded to.

In line with the 10-Year Health Plan, the Government is determined to shift more healthcare out of hospitals and into the community. The palliative and end of life care sector will have a big role to play in that shift.

Written statements

Hospices

Wes Streeting | Secretary of State for Health and Social Care

19 December 2024 | UIN HCWS348

Further reading

• House of Commons Library, Adult social care funding in England, 10 March 2025
• House of Commons Library, General Debate on Hospice and Palliative Care, 10 January 2025
• House of Commons Library, The UK’s changing population, 16 July 2024
• Parliamentary Office of Science and Technology, Palliative and end of life care, 27 July 2022