- Procuring services Funding children and young people’s palliative and end of life care
Funding children and young people's palliative and end of life care
Children and young people’s palliative and end of life care is provided by a range of organisations, including NHS, local authorities, charitable hospices and voluntary, community and social enterprise organisations. Consequently, it is important that integrated care boards (ICBs) consider the best use of investment to meet projected increased future demand and ensure a more sustainable and resilient funding model over time.
Support is available on the FutureNHS platform to help ICBs achieve a more sustainable approach as they identify and address any gaps in commissioning arrangements for palliative and end of life care to meet the needs of their local population. Palliative and end of life key services can be classified into commissioning categories to simplify the process of agreeing commissioning responsibilities across the various providers at a local level. This can improve the access, quality and sustainability of palliative and end of life care services. Briefly, these categories are:
- core activities – funded by ICBs and local authorities, including Continuing Care and Continuing Healthcare
- specialist activities – funded by ICBs
- enhanced activities – predominantly funded by third sector organisations and other non-NHS funding streams
Anyone requiring access to the FutureNHS platform should email england.palliativeandendoflife@nhs.net.
Integrated Care Boards
ICBs are the predominant funding source for core and specialist children and young people’s palliative and end of life care, irrespective of setting, but often in hospitals, community settings and children’s hospices. Examples include home-based or outreach community nursing, bed-based and specialist bed-based care and specialist medicines.
Specialist children and young people’s palliative and end of life care services often operate across regional footprints due to the low volume and high complexity of the care they provide. ICBs may need to fund tertiary services located outside of their own geographical footprints. ICBs can work with their neighbouring ICBs to commission these services.
Local Authorities
Consistent with their legal duties, local authorities have an important role in funding some core activities based on assessed need, including:
- a proportion of short breaks for respite
- aids and equipment
- adaptations for the home
- education services
- personal budgets
- integrated budgets
- social care
ICBs and local authorities working together to commission short breaks
Local authorities have a legal duty to provide short breaks for disabled children and their families. The NHS and local authorities have a legal duty to jointly commission services for disabled children as a result of the Children and Families Act 2014.
Charitable funding
Charitable funding is money raised by third sector organisations and then used to enhance the delivery of services. Such activities do not fall within the statutory duties of ICBs or local authorities but benefit the child, young person and/or their family in other ways.
NHS Specialised Commissioning
In NHS England’s roadmap for integrating specialised services within ICSs, ICBs will work in partnership with NHS England’s specialised commissioning team to fund NHS specialised services, which may include children with palliative and end of life care needs.