Members’ May policy update
Your go-to roundup of public policy developments this month.
UK-wide
Restoring Control over the Immigration System – White Paper published
On Monday 12 May, the UK Government published its Immigration White Paper, setting out a new plan to reduce net migration by prioritising domestic training and raising entry standards for overseas workers. While the White Paper does not specifically mention children’s palliative care, some of the proposed reforms could still have an impact on the sector.
One significant policy change is to increase the skilled worker visa requirement back up to RQF Level 6 (degree level) from RQF Level 3. This requirement was previously lowered in August 2020, a move that helped increase the proportion of skilled worker visas issued from 10% in early 2021 to 60% in early 2024. Increasing the requirement back up to RQF 6 could therefore restrict visa access for many health and social care roles that do not require a degree.
While the White Paper outlines the Government’s commitment to establishing a fair pay agreement for adult social care to mitigate the impact of ending overseas recruitment through the adult social care visa route, it makes no reference to a similar scheme for children’s social care.
Other key policy changes announced in the White Paper include:
- Introducing English language requirements across all immigration routes, including for dependents.
- Extending the time required to acquire settled status from five to ten years.
- Strengthening enforcement measures to ensure compliance with the rules.
Call for evidence: Inquiry into financial security and terminal illness
A new inquiry by the All-Party Parliamentary Group on Hospice and End of Life Care has been launched to investigate the financial challenges faced by people with a terminal illness.
As such, the inquiry is currently seeking evidence from those with lived, professional, or policy experience—focusing on how financial security varies by age, condition, background, and region.
The call for evidence is open until Friday 19 June 2025, with submissions accepted via form, video, or voice note.
You can find more information or respond to the call for evidence, here.
England and Wales
Update on Terminally Ill Adults (End of Life) Bill Report Stage
On Friday 16 May, MPs gathered in the House of Commons to debate amendments to the Terminally Ill Adults (End of Life) Bill. The debate focused on a series of amendments covering crucial areas including protections for medical practitioners, hospices and care homes, the procedure for accessing assisted dying under the Bill, and the eligibility and mental capacity of those seeking an assisted death.
Two amendments concerning the ability of professionals and organisations to opt out of involvement in assisted dying were put to a vote. Amendment NC10, which broadens the ability for individual medical professionals to opt out, was agreed to without a vote. However, a further amendment (a) to NC10, which would have allowed organisations or employers to opt out on behalf of their employees regardless of the employees’ own views, was defeated by 279 votes to 243.
During the debate, Dame Meg Hillier MP drew attention to the Bill’s potential implications for seriously ill children and young people. In addition to referencing the work of the Children’s Commissioner and the fact that children and young people have not really had a voice in the debate so far, Hillier highlighted the increased susceptibility of children and young people to external influence.
The debate will continue on Friday 13 June, when MPs will consider further amendments relating to topics such as approved substances and devices, advertising, inquests and death certification, monitoring and guidance, and the establishment of an Assisted Dying Commissioner. It remains uncertain whether all remaining votes will be completed that day. If not, they will carry over to Friday 20 June. The process will culminate in the Third Reading, during which MPs will vote on the Bill in its final form.
You can read the full debate transcript here.
Consultation on financial thresholds in charity law
The Department for Culture, Media and Sport is continuing to seek views on whether financial thresholds in charity law should be increased in line with inflation.
This follows a recommendation from the Law Commission’s 2017 report ‘Technical Issues in Charity Law’, which advised that thresholds in the Charities Act 2011 should be reviewed regularly. The government has committed to conducting such a review at least every 10 years, subject to resources.
The consultation is open until 11:45pm on 12 June 2025. You can respond online here.
England
Model integrated care board blueprint published
Earlier this month, NHS England (NHSE) published a co-produced model ICB blueprint co-produced with leaders from integrated care boards (ICBs). In clarifying the core functions of ICBs, the blueprint sets out how these statutory bodies will drive forward the Government’s 10-Year Health Plan and deliver the NHS’ three strategic shifts.
Of note is the fact that the blueprint sharpens ICBs’ focus on strategic commissioning. As such, almost a dozen operational functions—including workforce planning, primary care operations, digital leadership, estates strategy, medicines optimisation and sustainability—have been earmarked for transfer to emerging ‘neighbourhood health providers’, provider collaboratives or regional teams.
At the same time, ICBs are asked to grow and invest in functions central to population health including strategic planning, commissioning of neighbourhood services, health inequalities work, prevention and end to end pathways.
NHSE is clear that these transfers, although they support the goal of halving ICB management costs, do not substitute for it. As such, each ICB must reduce running costs to £18.76 per head by the end of Q3 2025/26, with all savings carried forward into 2026/27, and regional targets remain non negotiable.
While a national support offer is being made available to ensure fair and supportive treatment of staff affected by the transition, the blueprint is insistent on there being clear and accountable leadership throughout. As such, the blueprint also requires ICBs to streamline their leadership structures, reduce headcount at Board level where possible, and establish a dedicated Transition Committee to oversee risks and maintain governance.
For the full details, see the Model ICB Blueprint available here.
Delegation of directly commissioned services and transfer of staff to integrated care boards (ICBs)
At the beginning of April, NHS England successfully delegated responsibility for commissioning 70 specialised services to all integrated care boards (ICBs), although it retained overall accountability.
Following the Government’s decision to integrate NHS England into the Department of Health and Social Care, a review has now been commissioned to determine where accountability and responsibility for all NHS England direct commissioning functions should sit in the future. This review is scheduled to report back by the end of June 2025 and will inform future legislative decisions.
As a result, planned staff transfers in July will now be delayed until April 2026 to ensure a more joined-up approach. In the meantime, regional specialised commissioning colleagues will continue to provide services on behalf of ICBs, and all existing operational and policy engagements will continue as usual.
Updated guidance and toolkit published for Provider Selection Regime
NHS England has published updated statutory guidance to support relevant authorities in interpreting and applying the Provider Selection Regime (PSR).
The refreshed guidance reflects changes introduced by the Procurement Act 2023 and is designed to offer a clearer, simpler resource for commissioners and procurement professionals navigating the PSR.
Alongside the guidance, an updated implementation toolkit is now available to further support the effective application of the regime.
The updated guidance is available here and the toolkit can be accessed here.
The Commission on Palliative and End of Life Care volume one report launched
The Commission on Palliative and End of Life Care have published its volume one report. The report outlines many of the key challenges facing palliative care across the UK before providing a series of recommended actions to improve palliative care access, quality and sustainability.
We are pleased to have contributed to the Commission’s work and are committed to using the report to secure meaningful change for the children’s palliative care sector.
You can read the full report here.
Scotland
Assisted Dying for Terminally Ill Adults (Scotland) Stage 1 report and vote
On Tuesday 13 May, Members of the Scottish Parliament (MSPs) voted to pass Liam McArthur’s Bill to legalise assisted dying in Scotland. The vote on the Bill’s general principles passed by 70 votes to 56.
This vote follows the publication of the Committee for Health, Social Care and Sport’s Stage 1 report on the Bill. Having responded to the written call for evidence last year, we are really pleased to see a number of the concerns we raised reflected in the report. These include:
- The Bill’s definition of terminal illness is extremely broad which could lead to ambiguity when assessing the eligibility of young people with life-limiting and life-threatening conditions, whose prognosis is often uncertain.
- There is a need for greater clarity on the skills, experience and training that a professional should have to make the preliminary assessments and in turn, assist someone to die.
- The importance of strengthening the process for assessing capacity.
It is also good to see the Committee acknowledge concerns about the Bill’s potential impact on provider organisations, including children’s hospices and the wider palliative-care sector.
The Bill will now proceed to Stage 2 where it will return to the Health, Social Care and Sport Committee for detailed scrutiny. During this stage, any member of the Parliament may lodge amendments to alter the Bill.
You can read the Committee’s Stage 1 report here.
The Scottish Government has launched a consultation on a new integrated framework for long term conditions in Scotland
The Scottish Government has a number of strategies and policies in place to improve care and support for a range of long term conditions and condition groups. However, with many nearing the end of their planned timelines, the Government has begin reviewing its approach.
As such, a consultation on a new integrated framework for long term conditions in Scotland has been launched. The aim of this consultation is not to reassess local planning of services, but instead to help identify improvement priorities for long term conditions at a national level.
The deadline for responses is 20 July 2025. You can find out more, read the consultation paper, and share your views here.
Realistic Conversations in Paediatric Palliative Care: launch of new e-learning resource
NHS Education for Scotland (NES), in partnership with the Paediatric End of Life Care Managed Clinical Network (PELiCaN) have launched a new e-learning resource: ‘‘Realistic Conversations in Paediatric Palliative Care’.
The suite of learning, available on Turas, consists of six interactive modules including the following:
- Introduction to paediatric palliative care
- Introduction to Goals of Care
- Shared decision-making in paediatric practice
- Introduction to perinatal palliative care
- Supporting future care planning conversations in practice
- Realistic conversations in unscheduled care
Wales
Help shape the new service specification for palliative and end of life care in Wales
While it had been previously paused, the consultation on the National Service Specification for Palliative and End of Life Care has been reopened and will remain open for feedback until Friday 27 June 2025.
Developed by the National Programme for Palliative and End of Life Care in collaboration with key stakeholders, the specification establishes standards for the provision of high quality, equitable, and person-centred palliative and end of life care. It is therefore intended to serve as a guideline for managers, providers, and leaders within Health Boards, Trusts, and independent organisations.
Key principles included within the specification include delivering personalised care, ensuring early identification of those who could benefit from palliative care, and addressing holistic needs through tailored plans. The specification also promotes strong collaboration between services, prioritises workforce development, and expresses a commitment to tackling disparities in access to ensure all individuals receive the care they need regardless of where they live.
You can access the service specification and share your views here.