Palliative care services across the UK have been declared “inadequate” by a cross-party committee of MPs, which warns that dying people face a “postcode lottery” in their final moments, leaving many patients and their families in a state of fear and abandonment.
A System Under “Significant Pressure”
The Health and Social Care Committee, drawing on the work of its Independent Expert Panel, has concluded that palliative and end-of-life care services in England are under “significant pressure”. Providers are struggling to fund and commission the right care, leading to stark variations in support depending solely on where a person lives.
Committee chairwoman Layla Moran said it was “unthinkable” that specialist care for the dying was undervalued. “That is the heartbreaking reality that too many frightened patients and their families, including of young children, have to encounter during some of their most trying moments,” she stated.
The MPs’ report identifies a deeply fragmented system where patients and families struggle to navigate services with no single point of access. This “postcode lottery” is exacerbated because local NHS commissioners – Integrated Care Boards (ICBs) – often overlook palliative care due to competing financial pressures and a critical lack of data to understand local needs. Furthermore, less than half of local ICBs currently provide the recommended 24/7 palliative services, with the committee calling for this to be available nationwide.
The financial model is described as “unsustainable”. The report notes that insufficient funds are allocated to end-of-life care, with many services, especially for children, relying heavily on charity. Evidence suggests only a third of consultant-led children’s palliative care teams meet recommended staffing levels, with three-quarters dependent on charitable funding.
Dementia Patients “Missing Out” on Compassionate Care
The crisis in general palliative care is mirrored and magnified for people with dementia, according to a separate report by the charity Dementia UK. It concludes that individuals with dementia are “missing out” on timely, compassionate, and coordinated end-of-life care.
The report identifies “persistent gaps” in early planning and meaningful conversations about future needs, poor recognition of distressing symptoms, and an “overreliance” on crisis-driven care. This leads to avoidable hospital admissions, with more than a quarter of people with dementia dying in hospital despite a common preference to die at home.
A key issue is the limited and unfairly distributed access to specialist dementia nurses, known as Admiral Nurses. Dementia UK’s chief executive, Dr Hilda Hayo, noted that while 42% of former carers found Admiral Nurses the most beneficial resource, only 12% reported accessing one at the end of life. Dr Hayo said the government’s development of new national frameworks for both dementia and palliative care presented a “real opportunity” to fix this coordinated care.
Government Plans Meet With Skepticism
The government’s primary response to these systemic issues is the forthcoming Modern Service Framework (MSF) for palliative and end-of-life care in England, due for publication in Spring 2026. The Department of Health and Social Care intends the MSF to provide fresh guidance, support consistent care, and address variations in access, aligning with the wider 10-Year Health Plan’s ambition to shift care from hospitals to the community.
It is expected to include specific standards for children’s palliative care, requirements for 24/7 services, and plans to strengthen the specialist workforce, which the committee notes is “ill-equipped” and in critical shortage.
However, the Health and Social Care Committee has expressed profound scepticism. Ms Moran stated that under questioning, ministers’ answers “frequently reverted” to what may appear in the MSF and a related NHS workforce plan. “This Committee is sceptical of how much store has been set on the MSF, in particular when there has been no indication that additional resources are coming, other than one-off capital investments which will do little to tackle poor recruitment and retention,” she said.
The committee has called for concrete action alongside the framework, including a target for 90% of palliative care patients to be included on a dedicated Register prior to receiving care, to be monitored annually.