15 June 2026

Dear colleagues,

As you will be aware, integrated care boards (ICBs) have a statutory duty to commission palliative care and end-of-life care services in response to the needs of their population.

We are writing to all ICBs to highlight the written ministerial statement published on Thursday 4 June 2026, which provides an interim update on the Modern Service Framework for Palliative Care and End-of-Life Care. We are also asking ICBs to prioritise 2 actions to ensure progress is made towards strategic commissioning of palliative care and end-of-life care services.

As you know, the Strategic Commissioning Framework sets out how ICBs will focus on long-term population health strategy and planning and care pathway redesign. The framework states that ICBs will use national modern service frameworks and guidance to build the evidence base for new integrated models of neighbourhood care that maximise value, guiding the development of population health improvement plans.

Immediate actions for ICBs to improve palliative care and end-of-life care

Action 1: Produce an integrated needs assessment and understand service provision and utilisation

In line with the Strategic Commissioning Framework, all ICBs are expected to have completed an integrated needs assessment. This is based on a detailed understanding of their current and future population, including people of all ages with palliative care and end-of-life care needs, and is essential to commissioning services that meet people’s needs and deliver value for money.

In line with the Medium-Term Planning Framework, ICBs and relevant NHS providers should understand current and projected service utilisation and costs across their systems – including end-of-life care needs and services provided by hospices.

Action 2: Move to sustainable contracting of hospice services

While most palliative care and end-of-life care is provided by NHS staff and services, we recognise the vital contribution of voluntary sector organisations including hospices in supporting people and their loved ones.

However, funding and contracting for these services varies and does not consistently reflect population needs. Many hospices receive funding through grants. This is not sustainable. It makes it harder to monitor and evaluate services over time and undermines our ability to improve population health, ensure equitable access and delivery, and reduce health inequalities.

We are therefore asking ICBs to move to sustainable contracting of adult and children and young people’s hospice services based on their integrated needs assessments and to ensure that equity is a core objective of their commissioning. Initially, this will involve the move away from short-term grant funding for adult hospice services from 2027/28.

Support from NHS England

The end goal is for all ICBs to have clear and transparent contractual arrangements for commissioned hospice activity to meet their population health needs. You and your teams do not need to wait to begin this work.

We will refresh the statutory guidance and service specifications later this year to help ICBs take a system-wide approach to commissioning primary and community care, the voluntary sector, social care, and acute hospitals. However, you can start now by commissioning hospice services based on your integrated needs assessment.

Thank you for your continued work. We look forward to publishing the Modern Service Framework for Palliative Care and End-of-Life Care in the autumn.

Yours sincerely,

Dr Amanda Doyle OBE MRCGP
National Director for Primary Care and Community Services
NHS England

Publication reference: PRN02498