Hospices and Palliative Care (Hansard, 27 March 2000)

§ The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath)

At present, the National Health Service contribution to hospices is about 31 per cent or a third of their running costs. Specifying centrally what the proportion of NHS funding should be is not sensible, given the extent of local diversity both of services provided and alternative sources of local support. Therefore issues concerning the financial support for hospices are for local discussion and agreement.

The Health Improvement Programme (HimP) is and will continue to be the funding mechanism for palliative care services. Further HimPs will be set in the context of the priorities set in the National Priorities Guidance and Saving Lives: Our Healthier Nation, and will support the implementaion of National Service Frameworks at local level. These frameworks, together with the recommendations contained within Calman/Hine for cancer services, set out the way in which palliative care is addressed in each area as part of the Health Improvement Programme process. Voluntary healthcare providers are viewed as important players in the planning and provision of services and should be involved in this. From this should flow mote detailed plans for commissioning services, which will include arrangements for palliative care and the funding to be made available, giving hospices some long-term financial stability.

Health Improvement Programmes for the period April 2000 to March 2003 are due to he agreed and published by local health communities by the end of March 2000. It is too early to tell how many of these will address the need for hospice and palliative care. It is vital that all stakeholders are offered the opportunity to engage in the HimP process and influence strategy. Regional offices of the NHS Executive will monitor this process to ensure that all are actively contributing.

Health Service Circular 1998/99 stated that commissioners, including primary health care groups, need to work together with providers to develop a palliative care strategy which is right for their population based on health needs assessment. From the recent national survey of palliative care provision we know that at present about 50 per cent of health 54WA authorities have developed strategies for palliative care. We believe that a more comprehensive strategy is needed. This is currently being worked on within the wider cancer strategy and encompasses the Supportive Care Strategy, being developed by Professor Mike Richards, which has palliative care as one of the key components. Together these will lay the foundation for a tightly managed implementation programme.

An essential part of the Supportive Care Strategy is to develop standards and performance indicators for palliative care. This work is being taken forward as part of a quality improvement framework for cancer services and is being developed with the National Council for Hospices and Specialist Palliative Care Services. The standards and performance indicators will be piloted within a number of health authorities/regions over the coming months and will be rolled out nationally in April 2001. We are currently looking at what data items need to be collected to measure access and to develop a project plan for quality measurement of palliative care services. The Commission for Health Improvement will be the champion of high quality standards through a rolling programme of visits to NHS trusts and will also act as a "trouble-shooter" where necessary.