We are pleased to have now published an interim update on Modern Service Framework (MSF) for Palliative Care and End-of-Life Care in England, detailing the progress to date. The interim update was published via a Written Ministerial Statement, alongside an annex containing further information for interested parties, and importantly, the National Director for Primary Care and Community Services at NHS England is writing to systems setting out actions that can begin ahead of the full publication of the MSF in Autumn 2026. The Written Ministerial Statement is available at the following link:

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

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 voluntary sector organisations, including hospices, also play in providing support to people at the end of life and their loved ones.

The MSF will embed palliative care and end-of-life care within a strategic commissioning model that is centred on clear and transparent contractual arrangements for commissioned palliative care activity across all providers, including hospices, to meet population health needs, with explicit regard to reducing inequalities and improving outcomes for underserved and disadvantaged groups. NHS England is working closely with integrated care boards (ICBs) to support this process and, as detailed in the interim update, we are asking ICBs to move to sustainable contracting of adult, and children and young people’s, hospice services based on their integrated needs assessment. Initially, this will involve a move away from short-term grant funding for adult hospice services from 2027/28.

Whilst no specific assessment of the adequacy of statutory funding for hospices has been made, in February, NHS England wrote to all ICBs requesting an update on the financial stability of hospices in their footprint and the steps being taken to mitigate risks, as a matter of urgency. We are repeating this exercise, by asking ICBs and independent hospices, via Hospice UK, for an up-to-date assessment on their financial situation, risks, and mitigations.

In respect of guaranteeing equitable provision of hospice care, due to the way the hospice movement organically grew, hospice locations were largely not planned with a view to providing even access across the country or to prioritise areas of greatest need based on demographics. Therefore, there are inequalities in access to hospice services, especially for those living in rural or socio-economically deprived areas. However, the Government agrees that palliative care and end-of-life care must be provided equitably, through a range of professionals and providers, both generalist and specialist, across the NHS, social care, and voluntary sector organisations, including hospices.

We are pleased to have now published an interim update on Modern Service Framework (MSF) for Palliative Care and End-of-Life Care in England, detailing the progress to date. The interim update was published via a Written Ministerial Statement, alongside an annex containing further information for interested parties, and importantly, the National Director for Primary Care and Community Services at NHS England is writing to systems setting out actions that can begin ahead of the full publication of the MSF in Autumn 2026. The Written Ministerial Statement is available at the following link:

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

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 voluntary sector organisations, including hospices, also play in providing support to people at the end of life and their loved ones.

The MSF will embed palliative care and end-of-life care within a strategic commissioning model that is centred on clear and transparent contractual arrangements for commissioned palliative care activity across all providers, including hospices, to meet population health needs, with explicit regard to reducing inequalities and improving outcomes for underserved and disadvantaged groups. NHS England is working closely with integrated care boards (ICBs) to support this process and, as detailed in the interim update, we are asking ICBs to move to sustainable contracting of adult, and children and young people’s, hospice services based on their integrated needs assessment. Initially, this will involve a move away from short-term grant funding for adult hospice services from 2027/28.

Whilst no specific assessment of the adequacy of statutory funding for hospices has been made, in February, NHS England wrote to all ICBs requesting an update on the financial stability of hospices in their footprint and the steps being taken to mitigate risks, as a matter of urgency. We are repeating this exercise, by asking ICBs and independent hospices, via Hospice UK, for an up-to-date assessment on their financial situation, risks, and mitigations.

In respect of guaranteeing equitable provision of hospice care, due to the way the hospice movement organically grew, hospice locations were largely not planned with a view to providing even access across the country or to prioritise areas of greatest need based on demographics. Therefore, there are inequalities in access to hospice services, especially for those living in rural or socio-economically deprived areas. However, the Government agrees that palliative care and end-of-life care must be provided equitably, through a range of professionals and providers, both generalist and specialist, across the NHS, social care, and voluntary sector organisations, including hospices.

The Government is developing a Palliative Care and End of Life Care Modern Service Framework (MSF) for England. I refer the hon. Member to the Written Ministerial Statement HCWS1087 I gave to the House on 24 November 2025.

Through our MSF, we will closely monitor the shift towards strategic commissioning of palliative care and end of life care services to ensure that services reduce variation in access to, and quality of, palliative and end of life care services at local and regional levels.

This is further made clear in the recently published Strategic Commissioning Framework and Medium Term Planning Guidance, which make clear the expectations that integrated care boards should understand current and projected total service utilisation and costs for those at the end of life, creating an overall plan to more effectively meet these needs through neighbourhood health.

The Government is developing a Palliative Care and End of Life Care Modern Service Framework (MSF) for England. I refer the hon. Member to the Written Ministerial Statement HCWS1087 I gave to the House on 24 November 2025.

Through our MSF, we will closely monitor the shift towards strategic commissioning of palliative care and end of life care services to ensure that services reduce variation in access to, and quality of, palliative and end of life care services at local and regional levels.

This is further made clear in the recently published Strategic Commissioning Framework and Medium Term Planning Guidance, which make clear the expectations that integrated care boards should understand current and projected total service utilisation and costs for those at the end of life, creating an overall plan to more effectively meet these needs through neighbourhood health.

Our recently published 10-Year Health Plan sets out that community-based advice and support will help more people die in their home rather than in hospital, while community teams will work closely with care homes and paramedics to share care plans to avoid people being taken to accident and emergency unless absolutely necessary. Teams can include hospice outreach staff and palliative care professionals. Additionally, rapid response teams will help symptom management, including pain.

The Government is developing a Palliative Care and End of Life Care Modern Service Framework for England. I refer the Hon. Member to the Written Ministerial Statement HCWS1087, which I gave to the House on 24 November 2025.

NHS England has published universal principles for advance care planning (ACP). These principles facilitate a consistent national approach to ACP in England. The principles focus on the importance of providing opportunities for a person and their family or carers to engage in meaningful discussions, led by the person concerned, which consider that person’s priorities and preferences, including place of care, when they are nearing the end of life. Further information is available at the following link:

https://www.england.nhs.uk/publication/universal-principles-for-advance-care-planning/

The Government is committed to publishing a 10-Year Workforce Plan to set out action to create a workforce ready to deliver the transformed service set out in the 10-Year Health Plan. The 10-Year Workforce Plan will ensure the National Health Service has the right people in the right places, with the right skills to care for patients, when they need it, including in palliative care and end of life care.

The Government is developing a Palliative Care and End of Life Care Modern Service Framework (MSF) for England. I refer the Hon. Member to the Written Ministerial Statement HCWS1087, which I gave to the House on 24 November 2025.

The Government is developing a Palliative Care and End of Life Care Modern Service Framework for England. I refer the Hon. Member to the Written Ministerial Statement HCWS1087, which I gave to the House on 24 November 2025.

The early identification of someone who has palliative and end of life care needs is vital. There are tools to aid clinicians in identifying those approaching the end of life, for example the Supportive and Palliative Care Indicators Tool and the EARLY toolkit. Further information on the Supportive and Palliative Care Indicators Tool and the EARLY toolkit is available, respectively, at the following two links:

https://www.spict.org.uk/the-spict/

https://www.england.nhs.uk/north-west/north-west-coast-strategic-clinical-networks/our-networks/palliative-and-end-of-life-care/for-professionals/early-toolkit-for-primary-care/

NHS England has published universal principles for advance care planning (ACP). These principles facilitate a consistent national approach to ACP in England. The principles focus on the importance of providing opportunities for a person and their family or carers to engage in meaningful discussions, led by the person concerned, which consider that person’s priorities and preferences, including place of care, when they are nearing the end of life. The universal principles for ACP are available at the following link:

https://www.england.nhs.uk/publication/universal-principles-for-advance-care-planning/

Our recently published 10-Year Health Plan sets out that community-based advice and support will help more people die in their home rather than in hospital, while community teams will work closely with care homes and paramedics to share care plans to avoid people being taken to accident and emergency unless absolutely necessary. Teams can include hospice outreach staff and palliative care professionals. Additionally, rapid response teams will help symptom management, including pain.

The Government is developing a Palliative Care and End of Life Care Modern Service Framework for England. I refer the Hon. Member to the Written Ministerial Statement HCWS1087, which I gave to the House on 24 November 2025.

NHS England has published universal principles for advance care planning (ACP). These principles facilitate a consistent national approach to ACP in England. The principles focus on the importance of providing opportunities for a person and their family or carers to engage in meaningful discussions, led by the person concerned, which consider that person’s priorities and preferences, including place of care, when they are nearing the end of life. Further information is available at the following link:

https://www.england.nhs.uk/publication/universal-principles-for-advance-care-planning/

The adult social care system is means tested and provides funded support for those with the least financial means. While the Department sets the minimum thresholds for accessing local authority support, local authorities have the discretion to set more generous thresholds if they choose.

We have heard from many families who have been impacted by high and unpredictable care costs, and we recognise their frustration at the situation in which they find themselves.

The Government has launched an independent commission into adult social care as part of our critical first steps towards delivering a National Care Service. The terms of reference are sufficiently broad to enable the commission to consider the affordability of care costs.

The Government has launched an independent commission into adult social care as part of our critical first steps towards delivering a National Care Service. The commission will start a national conversation about what care and support working age adults, older people, and their families expect from adult social care, including exploring the needs of unpaid carers who provide vital care and support.

Local authorities have duties to support unpaid carers and are required to deliver sustainable, high-quality care and support services.

We know that too many children and young people are not receiving the mental health care they need, and that waits for mental health services are far too long. We are determined to change that, as we recognise the importance of timely access to mental health support for children and the positive impact this can have on areas such as family life and educational outcomes.

Backed by an extra £688 million in Government funding this year, we are transforming mental health services, including hiring more staff and getting waiting lists down through our 10-Year Health Plan, so children can have the best possible start in life.

We will deliver on our commitment to get every child who needs it access to mental health support within school, and over the course of this year we will roll that support out to nearly a million extra children. Under Government plans, all pupils will have access to mental health support in school by 2029/30.

Palliative care services are included in the list of services an integrated care board (ICB) must commission. To support ICBs in this duty, NHS England has published statutory guidance and service specifications. The statutory guidance states that ICBs must work to ensure that there is sufficient provision of care services to meet the needs of their local populations, which can include hospice services being available within the ICB catchment area.

Whilst the majority of palliative and end of life care is provided by National Health Service staff and services, we recognise the vital part that voluntary sector organisations, including hospices, also play in providing support to people at the end of life and their loved ones.

Most hospices are charitable, independent organisations which receive some statutory funding for providing NHS services. The amount of funding each charitable hospice receives varies both within and between ICB areas. This will vary depending on demand in that ICB area, but will also be dependent on the totality and type of palliative and end of life care provision from both NHS and non-NHS services, including charitable hospices, within each ICB area.

I have tasked officials to look at how to improve the access, quality, and sustainability of all- age palliative and end of life care, included services provided by hospices, in line with the 10-Year Health Plan.

The Government has no current plans to introduce a system of patient registration for National Health Service dental practices.

Patients in England are not registered with an NHS dental practice, although many NHS dental practices do tend to see patients regularly, and some dental practices may operate local waiting list arrangements. There is no geographical restriction on which practice a patient may attend. NHS dentists are required to update their NHS website profiles at least every 90 days to ensure patients have up-to-date information on where they can access care.

The Government plans to tackle the challenges for patients trying to access NHS dental care with a rescue plan to provide 700,000 more urgent dental appointments per year. Integrated care boards have been making the extra appointments available from 1 April 2025. To rebuild dentistry in the long term and increase access to NHS dental care, we will reform the dental contract, with a shift to focus on prevention and the retention of NHS dentists.

The long waits for mental health services are being driven by increasing demand in a system in desperate need of change.

The Government is already responding by delivering new and innovative models of care in the community. As part of this, we have launched six neighbourhood adult mental health centres that are open 24 hours a day, seven days a week, to bring together community, crisis, and inpatient care.

NHS England’s Planning Guidance for 2025/26 makes clear that for this year, to support reform and improvements, we expect all providers to reduce the variation in children and young people accessing services and improve productivity.

We are also improving data quality, so we can support providers to understand the demand across their areas. Since July 2023, NHS England has included waiting time metrics for referrals to urgent and community-based mental health services in its monthly mental health statistics publication, to help services to target the longest waits.

The National Institute for Health and Care Excellence has published guidelines for the referral of patients who present with recurrent urinary tract infections (UTIs), which is available at the following link:

https://cks.nice.org.uk/topics/urinary-tract-infection-lower-women/management/recurrent-uti-no-haematuria-not-pregnant-or-catheterized/

There are specific referral criteria for women, compared to men and children. There are also guidelines in place for those who present to Pharmacy First. If the patient has had a history of UTIs, they are asked to see their general practice (GP) surgery, rather than being prescribed antibiotics by the pharmacy.

Patients with recurrent UTIs should be referred to secondary care to exclude other causes, perhaps through an ultrasound scan or a cystoscopy. Once cleared, patients may be prescribed prophylactic antibiotics.

The number of lower urinary tract symptom service clinics are locally managed and commissioned by integrated care boards, in accordance with local population need.

While there are no current plans to train GPs and urologists on recognising the symptoms of chronic UTIs, NHS England’s UTI reduction workstream was established as part of the delivery of the UK 5-year action plan for antimicrobial resistance 2019 to 2024. This workstream aims to enhance prevention, support early and accurate diagnosis, and improve the treatment of UTIs through identifying and adopting best practice, and through interventions for different population groups.

NHS England has also been working with other public bodies, including the UK Health Security Agency, to strengthen the guidance regarding the appropriate use of diagnostics, including dipsticks. GPs can request testing for chronic UTIs via several pathways, including at point-of-care, via community diagnostic centres, or via laboratories. Laboratories across England adhere to stringent quality standards, including the UK Accreditation Standard ISO 15189, and implement robust internal and external quality assurance schemes, ensuring the accuracy of the tests used.

The National Institute for Health and Care Excellence has published guidelines for the referral of patients who present with recurrent urinary tract infections (UTIs), which is available at the following link:

https://cks.nice.org.uk/topics/urinary-tract-infection-lower-women/management/recurrent-uti-no-haematuria-not-pregnant-or-catheterized/

There are specific referral criteria for women, compared to men and children. There are also guidelines in place for those who present to Pharmacy First. If the patient has had a history of UTIs, they are asked to see their general practice (GP) surgery, rather than being prescribed antibiotics by the pharmacy.

Patients with recurrent UTIs should be referred to secondary care to exclude other causes, perhaps through an ultrasound scan or a cystoscopy. Once cleared, patients may be prescribed prophylactic antibiotics.

The number of lower urinary tract symptom service clinics are locally managed and commissioned by integrated care boards, in accordance with local population need.

While there are no current plans to train GPs and urologists on recognising the symptoms of chronic UTIs, NHS England’s UTI reduction workstream was established as part of the delivery of the UK 5-year action plan for antimicrobial resistance 2019 to 2024. This workstream aims to enhance prevention, support early and accurate diagnosis, and improve the treatment of UTIs through identifying and adopting best practice, and through interventions for different population groups.

NHS England has also been working with other public bodies, including the UK Health Security Agency, to strengthen the guidance regarding the appropriate use of diagnostics, including dipsticks. GPs can request testing for chronic UTIs via several pathways, including at point-of-care, via community diagnostic centres, or via laboratories. Laboratories across England adhere to stringent quality standards, including the UK Accreditation Standard ISO 15189, and implement robust internal and external quality assurance schemes, ensuring the accuracy of the tests used.

The National Institute for Health and Care Excellence has published guidelines for the referral of patients who present with recurrent urinary tract infections (UTIs), which is available at the following link:

https://cks.nice.org.uk/topics/urinary-tract-infection-lower-women/management/recurrent-uti-no-haematuria-not-pregnant-or-catheterized/

There are specific referral criteria for women, compared to men and children. There are also guidelines in place for those who present to Pharmacy First. If the patient has had a history of UTIs, they are asked to see their general practice (GP) surgery, rather than being prescribed antibiotics by the pharmacy.

Patients with recurrent UTIs should be referred to secondary care to exclude other causes, perhaps through an ultrasound scan or a cystoscopy. Once cleared, patients may be prescribed prophylactic antibiotics.

The number of lower urinary tract symptom service clinics are locally managed and commissioned by integrated care boards, in accordance with local population need.

While there are no current plans to train GPs and urologists on recognising the symptoms of chronic UTIs, NHS England’s UTI reduction workstream was established as part of the delivery of the UK 5-year action plan for antimicrobial resistance 2019 to 2024. This workstream aims to enhance prevention, support early and accurate diagnosis, and improve the treatment of UTIs through identifying and adopting best practice, and through interventions for different population groups.

NHS England has also been working with other public bodies, including the UK Health Security Agency, to strengthen the guidance regarding the appropriate use of diagnostics, including dipsticks. GPs can request testing for chronic UTIs via several pathways, including at point-of-care, via community diagnostic centres, or via laboratories. Laboratories across England adhere to stringent quality standards, including the UK Accreditation Standard ISO 15189, and implement robust internal and external quality assurance schemes, ensuring the accuracy of the tests used.

As required by law, NHS England has assessed the impact of the proposed NHS Payment Scheme. This is available at the following link:

https://www.england.nhs.uk/wp-content/uploads/2025/01/25-26-NHSPS-Consultation-notice-C-impact-assessment.pdf

This impact assessment includes consideration of the impact on patient choice, as well as an assessment of the impact on patients, in line with NHS England’s public sector equality duty.

Attention deficit hyperactivity disorder (ADHD) patients will continue to benefit from the Right to Choose their provider at the point of referral. None of the proposed changes to the NHS Payment Scheme included in the consultation would change this.

Local integrated care boards (ICBs) are responsible for planning service provision in their local area, including for ADHD assessments. In doing so, ICBs should take account of waiting lists, considering how local funding can be deployed to best meet the needs of their local population.

We want to ensure that mental health support is available for all who need it. As part of our mission to build a National Health Service that is fit for the future, we will recruit an additional 8,500 mental health workers across mental health services in England to reduce delays and provide faster treatment.

Anyone in England experiencing a mental health crisis can now to speak to a trained NHS professional at any time of the day through a new mental health option on NHS 111. Trained NHS staff will assess patients over the phone and guide callers with next steps, such organising face-to-face community support or facilitating access to alternatives services, such as crisis cafés or safe havens, which provide a place for people to stay as an alternative to accident and emergency or a hospital admission.

Too many young people are not receiving the mental health care they need, including in London and we know that waits for mental health services are too long. As part of our mission to build a National Health Service that is fit for the future and that is there when people need it, we will recruit an additional 8,500 mental health workers across children and adult mental health services in England to reduce delays and provide faster treatment. We will also provide access to a specialist mental health professional in every school and roll out Young Futures Hubs in every community.

There are currently approximately 65 locally-funded early support hubs in England offering early easy access mental health interventions to thousands of children and young people aged between 11 and 25 years old including those from low-income families.

The Department is running an £8 million Shared Outcomes Fund project throughout 2024/25 to boost and evaluate the impact of 24 of these existing early support hubs, including two in London.