The Modern Service Framework for Palliative Care and End-of-Life Care was never intended to introduce new, ring‑fenced funding. Its primary purpose is to set the strategic direction for improving palliative care and end-of-life care, including reducing variation in access, quality, and outcomes across the system.

In the context of wider fiscal pressures, the focus is on ensuring that existing resources are used as effectively as possible, supported by a shift towards more strategic, population‑based commissioning.

The forthcoming Modern Service Framework (MSF) for Palliative Care and End-of-Life Care will include a delivery plan to support implementation of the framework. On 4 June, we published an interim update in the form of a Written Ministerial Statement, which is available at the following link:

https://questions-statements.parliament.uk/written-statements/detail/2026-06-04/hcws88

The MSF will support the shift to the strategic commissioning of palliative care and end of life care, based on the integrated needs assessment completed by the integrated care board. This supports the effective and equitable use of resources of services commissioned and contracted at a local level to meet identified population needs now and in the future.

The Government is developing a Modern Service Framework (MSF) for Palliative Care and End-of-Life Care, which remains on track for publication in Autumn 2026. On 4 June, we published an interim update in the form of a Written Ministerial Statement, which is available at the following link:

https://questions-statements.parliament.uk/written-statements/detail/2026-06-04/hcws88

The MSF will be a clinically led, evidence-based framework to support sustained improvement in outcomes and experiences for patients and carers, and to reduce unwarranted variation in access, experience, and outcomes.

It would not be appropriate to pre-empt the final contents of the MSF. However, our goal is that every person who needs palliative care or care at the end of life receives high-quality, personalised support, shaped by what matters to them, their families, and carers. This includes promoting earlier identification of need, better coordinated care, and improved communication with patients and those important to them.

Patients attending an emergency department are assessed on arrival by an appropriately trained clinician or healthcare professional using established clinical triage processes. Triage is intended to identify patients who require the most urgent assessment and treatment, with priority determined by clinical need and the severity of the patient's condition rather than by any single diagnosis or patient group.

Where patients have recognised palliative or end-of-life care needs, clinicians will take account of the patient's presenting condition, any relevant advance care plans or documented care preferences, and exercise clinical judgement when determining the most appropriate course of treatment or onward care.

There is no national urgent and emergency care policy that provides a separate triage category or automatic prioritisation process solely on the basis that a patient is identified as having palliative care or end-of-life care needs.

The Single Patient Record will support our wider integration work providing a single trusted source of patient information, including care plans, that will be available to providers of health and care enabling them to offer more seamless co-ordinated care across the range of health and care services. Our ambition is that, from 2028, patients in England will be able to view their Single Patient Record via the NHS App, starting with maternity and frailty.

We are developing a Modern Service Framework (MSF) for Palliative Care and End-of-life care. The MSF will provide a clinically led, evidence-based framework to support sustained improvement in patient and carer outcomes, including reducing both inequality and unwarranted variation. The MSF will provide the framework against which palliative care and end-of-life care will be improved across all settings, including hospital and community.

The MSF will build on the ambitions set out in the Neighbourhood Health Framework to improve the identification of people approaching the end of life by 10% and reduce non elective admissions and hospital bed days for people at the end of life by 10% by March 2029. We recognise that care can be planned more proactively, and unwanted emergency admissions avoided, through good palliative care in the community.

We are committed to working in partnership with men, academics, stakeholders, research funders, employers, service providers, and important sectors such as media and sport to implement the Men’s Health Strategy. This includes our Men’s Health Academic Network and Stakeholder Group.

We are scoping the work on media literacy and will consider the inclusion of issues surrounding anabolic steroids, image and performance enhancing drugs, and selective androgen receptor modulators.

We are committed to working in partnership with men, academics, stakeholders, research funders, employers, service providers, and important sectors such as media and sport to implement the Men’s Health Strategy. This includes our Men’s Health Academic Network and Stakeholder Group.

We are scoping the work on media literacy and will consider the inclusion of issues surrounding anabolic steroids, image and performance enhancing drugs, and selective androgen receptor modulators.

82 general practitioners have been recruited through the Additional Roles Reimbursement Scheme (ARRS) in the Leicester, Leicestershire and Rutland Integrated Care Board since October 2024. The data can be found in table 1 of the March 2026 ARRS claims file, at the following link:

https://digital.nhs.uk/data-and-information/publications/statistical/mi-primary-care-workforce-recruited-through-the-additional-roles-reimbursement-scheme-arrs/1-october-2024---31-march-2026

Phase 1 of the Carr-Hill review concluded in May 2026. The report and recommendations are currently with the Department for consideration. The review’s findings and recommendations will be published in due course by the National Institute for Health and Care Research, and MPs will be updated once the review’s findings are available.

Phase 2 of the review will comprise the technical development, testing, and modelling of alternative approaches. Timelines for the remainder of the Carr-Hill review, including subsequent publications, are being informed by the outputs of Phase 1 and will be confirmed in due course.

Implementation of any new approach to core general practice funding would be subject to ministerial decision and consultation with the General Practice Committee England of the British Medical Association, in the context of available funding and our commitment to substantively reform the General Medical Services Contract within this Parliament.

Phase 1 of the Carr-Hill review concluded in May 2026. The report and recommendations are currently with the Department for consideration. The review’s findings and recommendations will be published in due course by the National Institute for Health and Care Research, and MPs will be updated once the review’s findings are available.

Phase 2 of the review will comprise the technical development, testing, and modelling of alternative approaches. Timelines for the remainder of the Carr-Hill review, including subsequent publications, are being informed by the outputs of Phase 1 and will be confirmed in due course.

Implementation of any new approach to core general practice funding would be subject to ministerial decision and consultation with the General Practice Committee England of the British Medical Association, in the context of available funding and our commitment to substantively reform the General Medical Services Contract within this Parliament.

Our first ever Men’s Health Strategy, launched on 19 November 2025, announced the Suicide Prevention Support Pathfinders programme which will invest up to £3.6 million over three years in areas of England where middle-aged men face the greatest risk of suicide.

Locally, integrated care boards are responsible for working with local authorities to implement local multiagency action plans. National Health Service guidance, including the National Suicide Prevention Strategy for England, strongly encourages systems to ensure staff complete suicide awareness training, such as the Zero Suicide Alliance and Staying Safe from Suicide. Further information on the National Suicide Prevention Strategy, staff suicide awareness training, and NHS England’s Staying Safe from Suicide guidance is available at the following links:

https://www.gov.uk/government/publications/suicide-prevention-strategy-for-england-2023-to-2028

https://www.lpft.nhs.uk/contact-us/need-help-now/lincolnshire-sucide-safe/free-suicide-prevention-training

https://stormskillstraining.com/2025/04/30/staying-safe-from-suicide/

https://www.england.nhs.uk/publication/staying-safe-from-suicide/

The mental health topic guide within the general practitioner (GP) training curriculum also highlights the need for GPs understand and differentiate between stress, distress, mood disorder, and diagnosable mental illness. GPs should be able to communicate effectively, professionally, and sensitively with patients and assess risks to the patient’s safety. The assessment of risk and prevention of death by suicide is seen as a common part of GP work. The guide frames suicide as a critical component of risk assessment and patient safety. It states that GPs must assess risk as a priority, including risk of self-harm and suicide. However, the curriculum explicitly cautions that there are no validated scales that predict suicide and that clinical assessment must rely on history, context, and professional judgement.

The curriculum also expects GPs to understand the epidemiology of and risk factors for suicide, which would include the risk in men, as well as associations with depression and other mental illness, substance misuse, and adverse life events.

Our first ever Men’s Health Strategy, launched on 19 November 2025, announced the Suicide Prevention Support Pathfinders programme which will invest up to £3.6 million over three years in areas of England where middle-aged men face the greatest risk of suicide.

Locally, integrated care boards are responsible for working with local authorities to implement local multiagency action plans. National Health Service guidance, including the National Suicide Prevention Strategy for England, strongly encourages systems to ensure staff complete suicide awareness training, such as the Zero Suicide Alliance and Staying Safe from Suicide. Further information on the National Suicide Prevention Strategy, staff suicide awareness training, and NHS England’s Staying Safe from Suicide guidance is available at the following links:

https://www.gov.uk/government/publications/suicide-prevention-strategy-for-england-2023-to-2028

https://www.lpft.nhs.uk/contact-us/need-help-now/lincolnshire-sucide-safe/free-suicide-prevention-training

https://stormskillstraining.com/2025/04/30/staying-safe-from-suicide/

https://www.england.nhs.uk/publication/staying-safe-from-suicide/

The mental health topic guide within the general practitioner (GP) training curriculum also highlights the need for GPs understand and differentiate between stress, distress, mood disorder, and diagnosable mental illness. GPs should be able to communicate effectively, professionally, and sensitively with patients and assess risks to the patient’s safety. The assessment of risk and prevention of death by suicide is seen as a common part of GP work. The guide frames suicide as a critical component of risk assessment and patient safety. It states that GPs must assess risk as a priority, including risk of self-harm and suicide. However, the curriculum explicitly cautions that there are no validated scales that predict suicide and that clinical assessment must rely on history, context, and professional judgement.

The curriculum also expects GPs to understand the epidemiology of and risk factors for suicide, which would include the risk in men, as well as associations with depression and other mental illness, substance misuse, and adverse life events.

The Department and NHS England considered the potential impacts of expanding Advice and Guidance (A&G) as part of the policy development process, including through clinical input, established governance arrangements, and equalities considerations. A&G is intended to support timely clinical decision‑making and ensure patients are directed to the most appropriate care. National guidance is in place to support its safe and consistent use, and the use of A&G does not change existing clinical accountability or patient safety arrangements.

The Department has not held formal discussions with the General Medical Council (GMC) specifically on the impact of A&G on general practitioner (GP) indemnity or patient safety. The GMC’s role is to regulate individual professional standards rather than to co‑design or endorse contractual or service policy. These contractual changes do not alter existing clinical thresholds, professional duties or the central role of clinical judgement.

The Department and NHS England have engaged with the Care Quality Commission (CQC), alongside other system partners, to discuss the implementation of A&G, including in relation to patient safety. This has included multi‑agency discussions involving NHS England, the CQC, and the Health Services Safety Investigations Body. The CQC has identified a number of areas where further clarity and assurance is required, and NHS England is working with system partners to respond to these points. This engagement forms part of ongoing oversight of the safe implementation of A&G.

The contract does not change the clinical threshold for referral to specialist care. GPs should continue to make a clinical decision to refer for specialist care where that is in the patient’s best interests, and to request specialist advice where it is needed. GPs retain responsibility for referral decisions, and this model supports, and does not replace, clinical judgement.

Clinical responsibility remains with appropriately qualified clinicians at each stage of the pathway, supported by established regulatory, indemnity, and local governance arrangements, including patient safety.

While advice is being sought or acted on in primary care, the GP remains responsible for the patient’s overall clinical care and risk. Under this model, requests for specialist advice and referrals are clinically reviewed by a named consultant, with the aim of ensuring patients are directed to the most suitable pathway. The specialist is responsible for the quality and appropriateness of the advice they give, not for ongoing management or follow‑up unless they formally assume responsibility for the patient’s care. Specialists also have clinical responsibility from the point at which a specialist advice request is converted into a referral or if the specialist initiates investigations or treatment directly.

Where a local model is already established, or has been agreed between primary and secondary care, that provides timely specialist clinical assessment with clear accountability, this may continue with oversight from a named consultant.

The 2026/27 GP Contract embeds the previous A&G enhanced service funding into core practice funding. Following near universal uptake of the A&G Enhanced Service in 2025/26, the focus for 2026/27 is on stability and simplicity. Embedding the specialist advice model within the core contract recognises its role in routine clinical practice, removes annual signups, and provides more predictable funding while supporting consistent patient pathways.

The Department and NHS England considered the potential impacts of expanding Advice and Guidance (A&G) as part of the policy development process, including through clinical input, established governance arrangements, and equalities considerations. A&G is intended to support timely clinical decision‑making and ensure patients are directed to the most appropriate care. National guidance is in place to support its safe and consistent use, and the use of A&G does not change existing clinical accountability or patient safety arrangements.

The Department has not held formal discussions with the General Medical Council (GMC) specifically on the impact of A&G on general practitioner (GP) indemnity or patient safety. The GMC’s role is to regulate individual professional standards rather than to co‑design or endorse contractual or service policy. These contractual changes do not alter existing clinical thresholds, professional duties or the central role of clinical judgement.

The Department and NHS England have engaged with the Care Quality Commission (CQC), alongside other system partners, to discuss the implementation of A&G, including in relation to patient safety. This has included multi‑agency discussions involving NHS England, the CQC, and the Health Services Safety Investigations Body. The CQC has identified a number of areas where further clarity and assurance is required, and NHS England is working with system partners to respond to these points. This engagement forms part of ongoing oversight of the safe implementation of A&G.

The contract does not change the clinical threshold for referral to specialist care. GPs should continue to make a clinical decision to refer for specialist care where that is in the patient’s best interests, and to request specialist advice where it is needed. GPs retain responsibility for referral decisions, and this model supports, and does not replace, clinical judgement.

Clinical responsibility remains with appropriately qualified clinicians at each stage of the pathway, supported by established regulatory, indemnity, and local governance arrangements, including patient safety.

While advice is being sought or acted on in primary care, the GP remains responsible for the patient’s overall clinical care and risk. Under this model, requests for specialist advice and referrals are clinically reviewed by a named consultant, with the aim of ensuring patients are directed to the most suitable pathway. The specialist is responsible for the quality and appropriateness of the advice they give, not for ongoing management or follow‑up unless they formally assume responsibility for the patient’s care. Specialists also have clinical responsibility from the point at which a specialist advice request is converted into a referral or if the specialist initiates investigations or treatment directly.

Where a local model is already established, or has been agreed between primary and secondary care, that provides timely specialist clinical assessment with clear accountability, this may continue with oversight from a named consultant.

The 2026/27 GP Contract embeds the previous A&G enhanced service funding into core practice funding. Following near universal uptake of the A&G Enhanced Service in 2025/26, the focus for 2026/27 is on stability and simplicity. Embedding the specialist advice model within the core contract recognises its role in routine clinical practice, removes annual signups, and provides more predictable funding while supporting consistent patient pathways.

The Department and NHS England considered the potential impacts of expanding Advice and Guidance (A&G) as part of the policy development process, including through clinical input, established governance arrangements, and equalities considerations. A&G is intended to support timely clinical decision‑making and ensure patients are directed to the most appropriate care. National guidance is in place to support its safe and consistent use, and the use of A&G does not change existing clinical accountability or patient safety arrangements.

The Department has not held formal discussions with the General Medical Council (GMC) specifically on the impact of A&G on general practitioner (GP) indemnity or patient safety. The GMC’s role is to regulate individual professional standards rather than to co‑design or endorse contractual or service policy. These contractual changes do not alter existing clinical thresholds, professional duties or the central role of clinical judgement.

The Department and NHS England have engaged with the Care Quality Commission (CQC), alongside other system partners, to discuss the implementation of A&G, including in relation to patient safety. This has included multi‑agency discussions involving NHS England, the CQC, and the Health Services Safety Investigations Body. The CQC has identified a number of areas where further clarity and assurance is required, and NHS England is working with system partners to respond to these points. This engagement forms part of ongoing oversight of the safe implementation of A&G.

The contract does not change the clinical threshold for referral to specialist care. GPs should continue to make a clinical decision to refer for specialist care where that is in the patient’s best interests, and to request specialist advice where it is needed. GPs retain responsibility for referral decisions, and this model supports, and does not replace, clinical judgement.

Clinical responsibility remains with appropriately qualified clinicians at each stage of the pathway, supported by established regulatory, indemnity, and local governance arrangements, including patient safety.

While advice is being sought or acted on in primary care, the GP remains responsible for the patient’s overall clinical care and risk. Under this model, requests for specialist advice and referrals are clinically reviewed by a named consultant, with the aim of ensuring patients are directed to the most suitable pathway. The specialist is responsible for the quality and appropriateness of the advice they give, not for ongoing management or follow‑up unless they formally assume responsibility for the patient’s care. Specialists also have clinical responsibility from the point at which a specialist advice request is converted into a referral or if the specialist initiates investigations or treatment directly.

Where a local model is already established, or has been agreed between primary and secondary care, that provides timely specialist clinical assessment with clear accountability, this may continue with oversight from a named consultant.

The 2026/27 GP Contract embeds the previous A&G enhanced service funding into core practice funding. Following near universal uptake of the A&G Enhanced Service in 2025/26, the focus for 2026/27 is on stability and simplicity. Embedding the specialist advice model within the core contract recognises its role in routine clinical practice, removes annual signups, and provides more predictable funding while supporting consistent patient pathways.

Since the launch of the Men’s Health Strategy, significant work and focus has been on implementing the commitments set out in the strategy. For example, on 27 March 2026 the Men’s Health Community Fund, a £6.3 million programme, was launched in partnership with Movember and the People’s Health Trust. We have also established the Men’s Health Academic Network and Men’s Health Stakeholder Group to provide advice to the Department on implementation.

We will also work with the Men's Health Academic Network, the voluntary, community, and social enterprise sector, and wider stakeholders to develop and publish a one-year-on report, highlighting the improvements made and where future efforts will need to be targeted.

We welcome the findings from the Royal College of General Practitioners’ report on ‘Tackling the GP workload crisis’. Many of the recommendations align closely with our ongoing commitment to fixing the front door of the National Health Service by cutting red tape and ensuring general practitioners (GPs) can spend more time treating patients.

The 10-Year Health Plan sets out our commitment to delivering the recommendations of the Red Tape Challenge, including making improvements at the interface between primary and secondary care. These recommendations also highlight our ambition to improve customer service and experience through better patient communication, support and navigation, as well as strengthening underpinning infrastructure.

The report also mentions simplifying incentives such as the Quality Outcomes Framework (QOF), which for the 2025/26 GP contract year, was streamlined significantly, with 32 out of the 76 indicators retired to reduce administrative burden for practices. For the 2026/27 GP contract year, the QOF remains streamlined with 43 indicators.

We are continuing to work across government to better understand where additional burdens are being placed on general practice and, where possible, to remove unnecessary requirements and improve ways of working.

The Department does not hold a centrally consolidated breakdown of allocations to individual children and young people’s hospice, and so is therefore not able to publish this information.

NHS England has informed all integrated care boards (ICBs) of their allocations for the children and young people’s hospices in their footprint for 2026/27, amounting to circa £27 million in total for England.

NHS England has made clear that this funding is to be distributed by ICBs to eligible children and young people’s hospices and is not intended for reallocation to other services. To support this process, NHS England has also established an assurance process with clear steps and timelines, including regular oversight with ICBs, regional teams and hospices. Where ICBs are unable to meet the deadline, this is escalated to NHS England to ensure timely distribution.

A similar total allocation, adjusted for pay inflation, will be made available in each of the subsequent two years (2027/28 and 2028/29). Communications regarding future allocations will be sent once the 2026/27 process is complete.

The Department does not hold a centrally consolidated breakdown of allocations to individual children and young people’s hospices, and so is therefore not able to publish this information.

In line with the established arrangements, integrated care boards (ICBs) administer this funding to individual hospices on behalf of NHS England. This approach is consistent with National Health Service devolution, promotes a more consistent national approach and supports commissioners in prioritising the palliative care and end of life care needs of their local population.

NHS England has made clear that this funding is to be distributed by ICBs to eligible children and young people’s hospices and is not intended for reallocation to other services. To support this process, NHS England has also established an assurance process with clear steps and timelines, including regular oversight with ICBs, regional teams and hospices. Where ICBs are unable to meet the deadline, this is escalated to NHS England to ensure timely distribution.

NHS England spends approximately £750,000 annually funding the EMIS Web dispensing module. NHS England will work with relevant bodies, including the Department, to develop a longer-term approach regarding the way dispensing is funded, in advance of the expiry of the 12-month extension NHS England has put in place.

NHS England spends approximately £750,000 annually funding the EMIS Web dispensing module. NHS England will work with relevant bodies, including the Department, to develop a longer-term approach regarding the way dispensing is funded, in advance of the expiry of the 12-month extension NHS England has put in place.