A new report by the All Party Parliamentary Group (APPG) for Hospice and End of Life Care has found that despite a law passed in 2022, the way hospice services are commissioned in England is not fit for purpose.

As a result, the cross party group of MPs found that services hospices provide for dying people and their families, and the support they provide to the health system, are at risk.

Hospice UK, alongside the APPG, is calling for:

  • The UK Government to produce a national plan to ensure the right funding flows to hospices. This should include measures to support local Integrated Care Boards (ICBs) with their commissioning decisions to secure hospice funding now and into the future.
  • ICBs to commit to fully delivering the statutory requirement set out in the Health and Care Act 2022. This should include placing hospices on multi-year contracts, paying the full cost of commissioned clinical services, and offering hospices the same annual contract value increases as NHS services. 

Despite the legal requirement for ICBs to commission palliative and end of life care in the 2022 Health and Care Act, the report by the APPG found that the funding hospices receive from ICBs varies significantly across the country in a ‘postcode lottery’ effect.

ICB adult hospice spending per head of population ranged from £10.33 to just 23 pence, according to research from Hospice UK. The charity Together for Short Lives also recently revealed that statutory children’s hospice funding varied hugely from an average of £511 to £28 per child with a life limiting condition.

Evidence gathered by MPs also showed that hospices are not being commissioned on a level playing field with NHS services, as ICB funding often does not reflect the true cost of care. Over the last two years, 28% of ICBs provided annual increases to hospice contracts that were below increases offered to NHS services in their area, leaving hospices to foot the rest of the bill through further fundraising efforts.

Toby Porter, CEO of Hospice UK says:


“Because of our ageing population, the number of deaths in the UK is projected to increase by 25% by 2048. We need a national plan to ensure that everyone in the UK can die in dignity, and with access to the services they need. Hospices will be a vital ally to the Government and to local communities all around the country in meeting this growing need. A well-funded hospice sector will actually take pressure off other NHS and social care services, by preventing people who are dying from the trauma of inappropriate hospital admissions, spending hours in A+E or feeling stuck on a hospital ward.

The UK has a wonderful hospice sector, but needs a long-term plan for NHS funding. The current system is patchy, inequitable and unsustainable, and favours wealthier parts of the country over those that are more deprived. The recommendations in this report can support both national Government and ICBs to take the necessary steps to fully realise the benefits of the hospice sector for our ageing population. Action now will safeguard the vital role they play in our wider healthcare system.”


Hospices provide essential palliative and end of life care to 300,000 people and family members every year. They play an important role within the health and care system and in their local communities. The core clinical services that hospices provide, both in their inpatient units and the community, are an indispensable part of the health and social care system, despite not being fully funded by the state, with evidence showing that hospices significantly alleviate pressure on local NHS services.

This report highlights how the important work they do needs to be properly commissioned and funded, so hospices can continue to provide care and support to people now and long into the future.

The full report is available to read here.