This bill obliges the Secretary of State to publish, within 12 months of the Act coming into force, formal proposals for how NHS England should fund hospice clinical services. The required proposals must address allocations between hospitals and community palliative care, between adult and children’s hospices, distribution across local Integrated Care Board (ICB) areas, protection of core and specialist services, and stronger accountability for ICBs in financing hospice care.
The bill also requires the Secretary of State to lay a separate report before Parliament, within the same 12‑month window, assessing the potential merits of bringing six specific palliative‑care cost types—pharmacy, pathology, patient community equipment, palliative consultant costs, clinical nurse specialist services, and advance care planning—into the NHS funding framework. The measure does not itself change commissioning rules or budgets; it sets a statutory trigger for analysis and proposals that could inform future policy and fiscal decisions.
At a Glance
What It Does
The bill requires the Secretary of State to produce two deliverables within 12 months: (1) published proposals for how NHS England should fund hospice clinical services, and (2) a Parliamentary report assessing whether six named palliative‑care cost categories should be included in the NHS funding framework. It defines geographical allocation in terms of local ICB areas and asks for measures to safeguard core and specialist services and strengthen ICB accountability.
Who It Affects
Primary actors are NHS England, Integrated Care Boards, adult and children’s hospice providers (many of which are charities), palliative‑care clinicians and community equipment suppliers. Secondary impacts reach pathology and pharmacy service providers and commissioners who manage local NHS budgets.
Why It Matters
This bill flags a potential shift from charitable and ad hoc funding models toward more systematic NHS funding for hospice care. By forcing an official analysis and specific proposals, it creates a formal pathway for integrating palliative‑care costs into mainstream NHS commissioning — with implications for budgets, contracting, and service design.
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What This Bill Actually Does
The bill places two concrete duties on the Secretary of State, both with 12‑month deadlines after the Act takes effect. First, the Secretary must publish proposals setting out how NHS England would fund hospice clinical services.
Those proposals must consider multiple dimensions of funding: the split between hospital and community palliative services, separate treatment for adult and children’s hospices, geographic distribution mapped to local Integrated Care Boards, protections for both core and specialist services, and methods to increase the accountability of ICBs for funding hospice care.
Second, the Secretary must lay a report before Parliament that assesses whether six specific types of palliative‑care costs should be absorbed into the NHS funding framework. That report is a qualitative and potentially quantitative appraisal of pharmacy, pathology, patient community equipment, palliative consultant costs, clinical nurse specialist services, and advance care planning costs.
The bill requires analysis of the “potential merits” of inclusion — it does not itself mandate that NHS funding be changed or that these items be immediately commissioned by NHS England.Because the Act comes into force on the day it is passed and extends to England and Wales, the duties apply immediately to the Secretary of State for Health and Social Care; however, the practical effects are focused on NHS England and local ICBs. The proposals and the report will be important inputs if ministers or NHS bodies later decide to redesign commissioning arrangements, create new payment mechanisms, or allocate additional recurrent funding.
The bill leaves the choice of financing mechanisms open: proposals could recommend anything from direct NHS commissioning via ICB contracts, inclusion in national tariffs, targeted grants to hospices, or hybrid arrangements that preserve some charitable funding models.Practically, the bill forces policymakers to confront several operational questions they have often deferred: how to define the set of hospice clinical services for statutory funding; how to provide geographically equitable funding across ICBs with different needs and charity landscapes; and how to measure and protect specialist services that are low‑volume but clinically essential. The Parliamentary report gives MPs and stakeholders an evidence base to debate options, but any substantive shift in funding will still require separate policy and fiscal decisions.
The Five Things You Need to Know
The Secretary of State must publish hospice‑funding proposals within 12 months of the Act coming into force.
The required proposals must address funding allocations between hospitals and community palliative care, adult versus children’s hospices, geographic distribution across local ICB areas, safeguards for core and specialist services, and increased ICB accountability.
The Secretary of State must lay a Parliamentary report, within the same 12‑month period, assessing the merits of including pharmacy, pathology, patient community equipment, palliative consultant costs, clinical nurse specialist services, and advance care planning costs in the NHS funding framework.
The bill defines “geographical areas of England” for allocation purposes as local Integrated Care Board areas, tying any recommended distribution to ICB boundaries.
The Act comes into force on the day it is passed, extends to England and Wales, and may be cited as the Hospices and Health Care (Report on Funding) Act 2025.
Section-by-Section Breakdown
Every bill we cover gets an analysis of its key sections.
Publish proposals for NHS funding of hospice clinical services
This section creates the core obligation: within 12 months the Secretary must publish proposals for how NHS England should fund hospice clinical services. Practically, proposals must cover multiple funding dimensions — hospital vs community palliative care, adult vs children’s hospices, geographic allocation by local ICB, safeguarding of core and specialist services, and measures to increase ICB accountability. For implementers this means the policy product should include options for allocation methodology (e.g., needs‑based formulae, historical block grants, contract‑based commissioning, or tariff inclusion), performance and quality safeguards, and mechanisms to hold ICBs to account for delivering funded hospice services.
Parliamentary report on specific palliative‑care costs
This section requires a separate report assessing whether six named cost categories should be brought into the NHS funding framework. It is an analytical duty — not a directive to change funding. The practical implication is that the report should set out evidence on cost drivers, service models, potential beneficiaries, commissioning approaches, and fiscal consequences for the NHS. Stakeholders should expect the report to evaluate operational questions (how to route contracts, reimbursement rates, workforce implications) as well as equity concerns (which populations benefit from central funding vs local arrangements).
Extent, commencement and short title
This short section makes the Act effective immediately on passage, extends it to England and Wales, and sets its short title for citation. The cross‑jurisdictional note is consequential: while the duties focus on NHS England, the Act’s territorial reach covers Wales — creating a potential mismatch with devolved health responsibilities that will need to be navigated in implementation and any follow‑on policy work.
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Explore Healthcare in Codify Search →Who Benefits and Who Bears the Cost
Every bill creates winners and losers. Here's who stands to gain and who bears the cost.
Who Benefits
- Adult and children’s hospices: a formal proposal process increases the chance of more stable, predictable NHS funding and clearer commissioning routes, which could reduce reliance on charitable income and improve long‑term planning.
- Patients receiving palliative and end‑of‑life care: analysis and proposals could lead to more consistent access to clinical hospice services and to inclusion of items (like community equipment) that materially affect home‑based care.
- Palliative clinicians and specialist nursing staff: bringing consultant and clinical nurse specialist costs into commissioning discussions could stabilise funded posts and career pathways, improving recruitment and retention.
- Community equipment suppliers and pharmacy/pathology providers: if the report supports inclusion, these suppliers could access NHS contracts and more predictable demand, improving supply continuity.
- Integrated Care Boards: clearer statutory expectations on accountability for hospice funding can give ICBs a mandate to commission comprehensive palliative pathways and to plan across health and social care boundaries.
Who Bears the Cost
- Department of Health and Social Care / HM Treasury: any subsequent move to fund hospice services from NHS budgets will create fiscal pressures and require either reprioritisation or new funding allocations.
- Integrated Care Boards: the bill increases accountability pressure on ICBs and may require them to commission and fund services previously delivered with charitable top‑ups, adding commissioning workload and potential budgetary strain.
- Hospice charities and voluntary sector operators: while potential statutory funding may help stability, charities risk reduced autonomy, new compliance burdens, and the loss of discretionary income streams or local fundraising advantages.
- Local commissioners and contract teams: implementing new funding models (tariff, block contracts, grants) will require procurement, contracting, monitoring and possibly dispute resolution capacity that many local teams lack today.
- Private pathology and pharmacy contractors: inclusion in the NHS framework could change contracting terms and prices, and may expose small suppliers to NHS procurement rules and payment timing pressures.
Key Issues
The Core Tension
The central dilemma is between securing sustainable, equitable funding for hospice clinical services through formal NHS mechanisms and preserving the independence, local responsiveness, and innovation that many charitable hospices deliver; standardising funding improves equity and workforce stability but risks bureaucratising services and eroding the charitable sector’s flexibility.
The bill forces a useful and overdue analysis but leaves many implementation choices—and the largest political and fiscal choices—unaddressed. It does not specify what “inclusion within the NHS funding framework” means in practice: inclusion could range from direct NHS commissioning and payments to ICBs, to national tariff adjustments, to ring‑fenced grant funding.
Each option has different implications for equity, administrative complexity, and costs. The proposals and report will need to confront valuation of specialist services (low volume, high skill), cross‑subsidy arrangements where hospices currently top up NHS payments, and how to preserve community‑centred models that charities often provide more flexibly than statutory services.
Another unresolved question is the territorial interplay with devolved administrations. The Act extends to England and Wales but the substantive hooks are to NHS England and local ICBs; Wales has its own NHS structure and funding decisions.
That mismatch could complicate any follow‑on policy that seeks to standardise hospice funding across the two territories. Lastly, the bill mandates analysis but includes no enforcement mechanism or obligations on ICBs beyond a call for “increased accountability,” leaving scope for contested interpretations about what ICBs must do if ministers accept the proposals or the report’s recommendations.
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