Social investment in end of life care

Most people (63%) would prefer to die at home; however, only 21% of people across England and Wales die at home. More than half currently die in hospital – the place where they are least likely to want to die.

Community palliative and end of life care services are under-invested in and do not have the capacity to meet current needs, much less the increased demand expected from 2015.

In order to meet the growing burden on costly acute and crisis care at end of life, we need to find new ways to fund and deliver palliative and end of life care, and improve its effectiveness, efficiency and capacity.

Social investment models are a way of attracting new investment to tackle social challenges. Social investment aims to incentivise better delivery, provide the level of upfront funding required for new responsive services and share the risk between commissioners, investors and providers.

The partnership

The end of life care social investment initiative between Marie Curie and the Sandwell and West Birmingham Clinical Commissioning Group   is the UK's first healthcare project of this type.

We're working with key supporting partners, including the NHS Confederation, NHS
Clinical Commissioners
, Social Investment Business, Bevan Brittan, Social Finance and Unipart, to explore the application of social investment models to transform end of life care. The project is funded by the Social Investment Business and is supported by the Department of Health.

The project will explore how social investment can transform end of life care and enable patient choice; ensuring that the right treatment and support is delivered at the right time.

The opportunity

Developing a social investment model will support the financing and delivery of integrated community end of life care at scale. If successful, it will:

  • establish a proof of concept for social investment in community end of life care
  • help service commissioners deliver high quality integrated care, meeting the needs of patients
  • enable more people to be cared for in the community, delivering choice at end of life
  • reduce the use of acute and crisis care, delivering efficiency and productivity benefits

The project will also develop new contract mechanisms and structures that support the integration of end of life care across an area and test payment by results incentives to deliver patient choice and improve the quality and efficiency of services.

Pilot social finance products have been developed in other public sector contexts, including reducing re-offending in Peterborough, tackling homelessness in London and supporting vulnerable adolescents and families in both Essex and Manchester. This project will build on the results of these and other schemes.

The end of life care sector is well placed to explore the potential of social finance, because of the strong evidence for the value of community end of life care services, as well as the sector's wide experience of working in partnership to develop integrated care models.

Key facts and figures

  • Up to 142,500 people a year in England do not receive the end of life care that they need.
  • Demand for palliative and end of life care is due to rise from 2015.
  • Demand will also become more complex because of an increasingly ageing population and prevalence of comorbidities (when someone has more than one illness or other medical problem).
  • There are also significant variations in the nature of services accessible across the country.

For further information:

Please contact Meeta Kathoria, Head of Programmes, at or call 020 7599 7277.

Contact the press office for media and press enquiries.

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