The Rt Hon Andy Burnham MP
10 Downing Street,
London
SW1A 2AA
Matthew Reed
Marie Curie
One Embassy Gardens
8 Viaduct Gardens
London SW11 7BW
11 September 2026
Dear Prime Minister,
Both before taking office, and in recent weeks, you have made much welcomed public comments acknowledging the need to address the parlous state of palliative and end of life care in our country.
You are though yet to set out what your government proposes to do about this crisis of growing scale and devastating impact for families across the UK. I am therefore writing to you now to ask you to articulate - with the urgency and ambition with which you are approaching other areas of public policy - what you intend to do to close the gaps in end-of-life care and ensure that all dying people get the dignified care and support they need.
The manner in which we as a nation support people towards the end of their lives is a key marker of a civilised society. It shows our true sense of community and justice. Patients consistently tell us what matters most at the end of life: being free from pain and other distressing symptoms, maintaining dignity and self-respect, feeling safe, being surrounded by loved ones, and being involved in decisions about their care.
But for far too many people today, experiences of the end of life are marked not by care and dignity, but by avoidable pain, poverty, and significant uncertainty around where to turn for help. Our recent research identifies that nearly one in three dying people have unmet palliative care needs. That equates to over 200,000 people across the UK each year not receiving the care and support they need at the end of their lives. There is currently a postcode lottery in access to services, and concerningly, there are barriers to access for particular groups, such as people with non-cancer conditions, people living in poverty, those who live in rural areas, and some minoritised ethnic communities, making the lack of end of life care a fundamental issue of social justice.
With our population ageing, without additional significant intervention this figure will only grow. We believe the UK can and must do better than this, and the actions required to ensure that everyone can have the care we would aspire for our own loved ones quite achievable.
Marie Curie maintains a neutral position on assisted dying – we neither campaign for nor against a change in the law. Yet with the return of the Terminally Ill Adults (End of Life) Bill to the House of Commons this week, the need for more urgent and ambitious action to fix end of life care could not be clearer. Throughout previous debates on assisted dying, a significant consensus has emerged that palliative care must be improved regardless of whether the law changes on assisted dying or not. We fervently agree. But warm words won’t fix our broken palliative care system- we now need decisive action. And it is incumbent upon you as our Prime Minister to set out how you will deliver it.
Under your predecessor, some significant progress has been made. The 10-Year Health Plan for England sets out an ambition to shift care from hospital to community, centred on the development of a neighbourhood health service: a crucial aim for patients approaching the end of life who currently aren’t able to access the care they need 24/7 and closer to home.
The Neighbourhood Health Framework sets out an aim to increase the number of people identified as approaching end of life by 10% and reduce non-elective admissions and hospital bed days for this cohort by 10% over the next 3 years. And the Department for Health and Social Care is currently developing the first new national plan for palliative care and end of life care since 2008, in the form of a Modern Service Framework, which will set out an ambition for change.
NHS data on patterns of care shows that in England 14% of all emergency admissions to hospital, and 30% of all bed days spent in hospital, involve people in the last year of life.
The current lack of adequate access to palliative care in the community means that dying people and their carers often have no alternative but to attend A&E, call out an ambulance or be admitted to hospital at crisis point when they need help. That is not delivering care where many patients want to be, and it is extremely costly for our NHS. Realising the Government's ambition to reduce non-elective admissions and hospital bed days for people approaching the end of life by 10% could generate annual savings of up to £790 million across acute hospitals in England.
In order to drive rapid improvements in people’s experiences of end-of-life care across our country, a major delivery effort will be required. That’s why, we are calling on your Government to now accelerate and deliver the much-delayed Modern Service Framework, supported by a time-limited 3-year palliative care and end of life care transformation fund to enable its delivery and catalyse the scale of change required. This wouldn't be about pouring more money into the status quo; it’s about enabling a transformed approach and focus within the ‘cradle-to-grave NHS’ to ensure patients get access to the care they need and deserve at the end of their lives.
Alongside wider action on workforce, strategic commissioning, and accountability across all health and care settings, this would represent a substantial but proportionate investment to begin delivering the improvements in palliative care that are so desperately needed, while supporting the Government's wider ambitions for more joined-up, community-based care.
Dying people simply can’t wait any longer. We must urgently seek to close the gaps in end-of-life care and ensure that all dying people get the care and support they need. I sincerely hope that you will clearly articulate your plans to achieve this goal at the earliest opportunity. We stand ready to face into this challenge and work alongside your government and our wider health system to fix end of life care for good.
Yours sincerely,
Matthew Reed
Chief Executive Officer, Marie Curie