22,000 people will die without the care they need during MPs summer recess, Marie Curie warns

While Parliament is in summer recess, more than 22,000 people in England will die without the care and support they urgently need. End of life charity Marie Curie is urging the new Prime Minister Andy Burnham to make fixing end of life care a priority for his government and deliver the funding needed to transform care for people at the end of their lives.

In a letter to the Prime Minister, Marie Curie will call on the UK Government to establish a three-year, £200 million-a-year Palliative and End of Life Care Transformation Fund to support the delivery of the forthcoming Modern Service Framework (MSF) and the shift from hospital to community care set out in the NHS 10 Year Plan.

Marie Curie stresses that this is not a call for additional long-term funding for the healthcare system, but a targeted, time-limited investment to unlock better value from the £9.5 billion already spent each year on healthcare in the final year of life. This funding would act as a catalyst for change, supporting service redesign and the scaling of proven care models that improve patient outcomes while reducing avoidable hospital admissions and stays. Currently, 81% of this spending is directed towards hospital care, compared with just 11% for primary and community services. As a result, too many people are unable to spend their final days in the place they would choose.

A dedicated transformation fund would support local health systems to redesign services, scale proven models of care, and accelerate the Government’s ambition to shift care from hospitals into communities. By investing in effective, cost-efficient approaches, the fund would help reduce avoidable hospital admissions and ensure people receive coordinated, person-centred support closer to home. This upfront investment would help rebalance resources away from crisis-driven care and towards services that prevent avoidable hospital stays, improving experiences and outcomes for patients and families while easing pressure on the NHS.

The economic case is clear:

Alongside the transformation fund, Marie Curie is calling for stronger commissioning and accountability arrangements to ensure the Modern Service Framework delivers lasting improvements in care.

Matthew Reed, Chief Executive of Marie Curie, said: "While Parliament is away for the summer break, more than 22,000 people in England will die without the care and support they need. Every one of those people is someone's parent, partner, sibling, friend or neighbour.

Marie Curie says existing funding is not being directed where it can have the greatest impact.

Matthew Reed added: "Fixing end of life care means fixing commissioning. Charities should not be left plugging gaps in statutory care provision.

A: Because too many people are not getting the care and support they need at the end of life. Nearly one in three dying people are estimated to have unmet palliative care needs, with recent research defining unmet palliative care needs as present when a person with a life limiting illness has symptoms, psychosocial concerns, or care requirements that are not adequately addressed through available services, with inability to access or receive person centred care. At the same time, the Government is developing a new Palliative Care and End of Life Care Modern Service Framework, the first national plan for end of life care in almost two decades. This is a once-in-a-generation opportunity to fix a system that is failing too many people.

A: Too many people reach crisis point because they cannot access the care and support they need in the community. As a result, they often rely on ambulances and end up in hospital unnecessarily, despite most people wanting to be cared for, and to die, at home if possible. Families and carers are often left navigating a fragmented system and can struggle to access support outside normal working hours. This causes distress for patients and those close to them, while placing avoidable pressure on the NHS.

A: We are calling on the Prime Minister to establish a dedicated Palliative and End of Life Care Transformation Fund, providing £200 million a year for three years. This would be a time-limited investment to help local health systems redesign services, scale proven models of care and accelerate the shift from hospital-based care to community-based support for people at the end of life.

A: The Government has set out an aim of delivering a 10% increase in identification of dying people, and a 10% reduction in inpatient bed days for people at the end of life love the coming three years. These are major ambitions, which if realised would deliver up to around £800m of savings from inpatient care costs. A bold ambition requires bold action to match it. The £200m figure set out is purely indicative of the scale of investment that would be needed to make a significant contribution to the Government’s aims for end of life care - whilst still representing only a proportion of the savings which could accrue if the Government meet their aims.

Q: Is Marie Curie asking for more money for the NHS overall? A: No. This is not a call for new, in perpetuity, additional spending in the NHS. It is a proposal for targeted, time-limited investment to help make better use of the £9.5 billion already spent each year on healthcare for people in their final year of life. The fund would act as a catalyst for change, helping local systems shift resources towards care that delivers better outcomes and avoids unnecessary hospital use.

A: The Government has made clear that it wants to move more care out of hospitals and into communities. Without clear plans and resourcing to enable that to happen for patients at the end of life, government is unlikely to realise its ambition. Currently, 81 per cent of healthcare spending for people in their last year of life goes to hospitals, while just 11 per cent supports primary and community care. We have an opportunity to rebalance the system so more people receive the care they need in the place they choose.

A: We envisage the transformation fund supporting investment in cost-effective, innovative, and integrated models of palliative and end-of-life care that better meet population need and reduce avoidable pressure on acute services. The focus would be on interventions that improve early identification, care coordination, and access to community-based support, helping people receive care in the most appropriate setting and reducing unnecessary hospital admissions and bed days.

Examples could include embedding palliative care specialists within emergency departments to identify patients approaching the end of life and, where appropriate, facilitate rapid transfer to their preferred place of care; equipping paramedics with the skills, decision-support tools and medication needed to manage palliative care needs in the community without conveying patients to hospital; or funding clinical nurse specialists to work alongside GP practices to identify patients earlier, support personalised care planning and coordinate care across neighbourhood teams.

The fund would be allocated to Integrated Care Boards (ICBs) based on a clear local strategy for delivering a sustained shift in how end-of-life care is provided. While ICBs should have flexibility to design solutions that reflect local needs and priorities, investment should be targeted towards interventions that contribute to the Government's stated ambitions of:

By linking investment to these outcomes, the fund would support both improved patient experience and more efficient use of NHS resources, while creating the foundations for long-term transformation beyond the initial funding period.

A: Better palliative care and end of life care help people receive the care and support they need, manage pain and other symptoms, and maintain the best quality of life. It means more people can be cared for at home and die in a place of their choosing rather than experiencing avoidable hospital admissions. It also ensures that families and carers are better supported, and people can die with dignity and comfort at the end of life.

A: Better community support can reduce avoidable ambulance callouts, A&E attendances and emergency hospital admissions. Around 14 per cent of all emergency hospital admissions involve people in their last year of life, while more than half of healthcare spending on this group is spent on emergency hospital care. With the right support in place in community settings, more people can be cared for closer to home, avoiding unnecessary hospital use and improving experiences at the end of life. This is better for patients and a more effective use of NHS resources.

A: The Government's Neighbourhood Health Framework includes an ambition to reduce end of life inpatient bed days by 10 per cent. Achieving that target could deliver annual savings of between £775 million and £790 million. The £200 million annual transformation fund would represent just over a quarter of these potential savings and could help create the conditions needed to achieve them.

A: We are advocating for a three-year transformation fund to pump-prime the shift from hospital-based care to community-based end-of-life care. The funding would be used to catalyse new models of care that can deliver sustainable, long-term change beyond the initial investment period. One potential route to sustainability is a social investment approach. Reduced non-elective admissions and shorter hospital stays at the end of life would generate significant savings for the acute sector through lower demand. The transformation fund could provide the upfront investment needed to establish and scale community services designed to achieve these outcomes.

Under this model, outcome payments would be made by the acute sector to service providers only where agreed reductions in hospital utilisation had been successfully delivered. This would create a sustainable funding mechanism for effective community services while ensuring that costs transfer to the acute sector only after corresponding savings have been realised.

As a result, the fund would not simply support services for a limited period but would act as a catalyst for a lasting shift in care delivery, improving patient outcomes while reducing pressure on hospitals.

A: This is a rare opportunity where compassion and economic sense align. Improving end of life care would help hundreds of thousands of people receive better support, reduce pressure on hospitals, and deliver significant savings for the NHS. If the Prime Minister wants to build an NHS that is centred on people rather than institutions, there are few better places to start.

A: Every family deserves the chance to spend life's final chapter with dignity, comfort and support. The Government now has a unique opportunity to transform care for dying people and their loved ones. By investing in end of life care today, we can improve experiences for patients and families, reduce pressure on the NHS, and make better use of public money. The opportunity is there; we cannot afford to miss it.