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Leaders’ Briefing

Keeping you up to date on sector news and our work

Key updates

UK-wide

Nuffield Trust publishes report on lessons the UK can learn from countries that have legalised assisted dying

In August, the Nuffield Trust published a new report reviewing the evidence from countries where assisted dying has been legalised. Specifically, the report focuses on the challenges the health and care system might face if assisted dying is legalised, and what can be learnt from experience elsewhere.

Key learnings noted in the report included:

  • Infrastructure for implementation: In many countries, the introduction of assisted dying has required new processes, data systems, organisations, and in some cases new types of staff to monitor compliance, ensure safety and support access to services. Additionally, implementation in other countries has seen government guidance issued and formal reports produced to monitor access and identify service gaps.
  • Capacity and resources: Building the required capacity for assisted dying has been a key challenge in many countries. The report notes that UK planning must go beyond direct costs, for example for staff directly involved, and consider the wider costs to develop the infrastructure to support the implementation of assisted dying.
  • Impact on individuals, families and carers: While there was limited evidence of the experience of people who have (or seek) an assisted death, the available evidence suggests that barriers to accessing an assisted death remain a key concern. Existing at individual, organisational and system levels, key barriers include: geography, health literacy and cost.
  • Impacts on staff and organisations’ engagement and experience: According to the report, staff involved in end of life care are often those most likely to be delivering assisted dying services, with general practitioners most often directly involved. The report stresses the need for staff training and support with key staff groups such as nurses and pharmacists often missing out.

The report then goes on to make a series of recommendations covering:

  • Regulation and infrastructure
  • Funding
  • Workforce issues
  • Equity and access
  • Data and monitoring

You can access the full report here.

One in 10 eligible families missing out on disability living allowance (DLA) support

Recent figures on unfulfilled eligibility in the benefit system released by the Department for Work and Pensions have revealed that 1 in 10 eligible people are missing out on DLA support. As a result, more than £850 million in Disability Living Allowance went unclaimed last year.

This benefit provides financial support for children with disabilities who need additional care or face mobility challenges. The benefit offers funding towards specialist treatments, equipment, such as hearing aids, home modifications, and assistance with everyday living including transport.

Upon reaching 16, young people are typically moved across to Personal Independent Payment (PIP). However, based on the most recent statistics, Personal Independence Payment (PIP) also sees people missing out on the benefit.

You can read more here.

England

Ending children’s palliative care postcode lottery now Lib Dem party policy

Liberal Democrats have voted to adopt a policy which states that the palliative care postcode lottery must end for children. The decision, made at the party’s recent Autumn conference, calls for a national strategy to improve the availability of 24/7 palliative and end of life care support in community settings.

The Liberal Democrats are pressing for guaranteed ringfenced NHS funding for children’s hospices with annual uplifts so that it reaches a minimum of £30 million by 2030. They are also calling for a review of the way in which children’s palliative care is planned and funded.

We’re working with the Liberal Democrats and all of the political parties at Westminster to make sure that seriously ill children across England can access sustainable palliative care, when and where they need it, in hospital, in the community and in children’s hospices.

New regional NHS structure published

With the 10-year health plan committing to a reshaping of the NHS operating model in England, a model region blueprint has now been issued to chairs and chief executives of all provider trusts, foundation trusts and integrated care boards. This blueprint sets out how seven regional teams, under the Department for Health and Social Care (DHSC), will operate from April 2027.

The blueprint outlines three core functions for these regions:

  • Regional strategic leadership: Supporting the delivery of reform, overseeing planning, investment and reconfiguration of services, supporting innovation and ensuring effective regional leadership strategy and talent pipelines.
  • Performance management: Providing holistic oversight of provider and ICB performance, assessing board and leadership capability and monitoring risk.
  • Improvement and intervention: Ensuring high-quality, sustainable care by developing system capability, addressing underperformance and overseeing regulatory interventions.

The blueprint builds on the Darzi review’s call for a rules-based model with clear roles and fewer overlaps and identifies three essential conditions: vertical coherence (clear roles and no duplication), horizontal coherence (aligned functions and capabilities), and the right culture and ways of working.

In addition to defining the regional functions, the blueprint indicates that a broader remit is to come for regional teams:

  • Regional teams will start as primarily NHS teams but they may expand to cover the DHSC’s wider responsibilities including the coordination of social care and public health.
  • Seven regional ‘offices of pan ICB commissioning’ will be set up this financial year and will gradually take on NHS England’s (NHSE) direct commissioning functions, such as specialised services.
  • Regions will maintain direct commissioning responsibilities ‘until safe transfer has happened’.

To enable this, the blueprint proposes strengthened governance with new regional CEOs and chairs, senior leaders with board-level experience, access to resources for transformation, and a unified ‘one team’ culture across DHSC and the NHS.

A briefing on the model region blueprint from NHS Providers is available to access here.

Update on clustering arrangements for integrated care boards

The NHS has published updated details on integrated care system (ICS) leadership and the upcoming clustering arrangements. While each Integrated Care Board (ICB) will remain a separate legal entity, many will operate through shared leadership and combined teams as part of newly formed clusters. In total, 26 clusters have been confirmed.

Clustering will begin in Q3 of 2025/26, with ICBs grouped regionally to improve coordination. Regions with clustering include parts of the East of England, London, Midlands, South East, and South West. Regions without clustering include most ICBs in the North East and Yorkshire, North West, and some in London and the South East.

You can find out more about clustering arrangements for your local ICB here.

First neighbourhood health services to be implemented in 43 places

The first 43 areas selected for England’s new national neighbourhood health implementation programme have been announced. Backed by £10 million in its first wave, the programme is intended to build on existing examples of neighbourhood working and aims to improve local health outcomes through more integrated and community-focused care.

Each area will have a programme lead who will coordinate with local services to establish a neighbourhood health team, built around General Practice. The team will include professionals such as community nurses, hospital doctors, social care workers, pharmacists, dentists, optometrists, paramedics, social prescribers, local government and voluntary sector partners.

These teams will provide joined-up, end-to-end care in the community. The initial focus will be on supporting people with long-term conditions like diabetes, arthritis, angina, high blood pressure, MS, or epilepsy in areas of highest deprivation, with plans to expand to other groups over time.

Some integrated care boards (ICBs), such as Suffolk and North East Essex and West Yorkshire, have multiple successful sites, while 12 ICBs, including Lincolnshire, Devon, and Norfolk and Waveney, had no areas selected. Each chosen site will receive support including coaching, expert advice, regional workshops, and access to a peer-learning hub.

Martha’s Rule rolled out to all acute hospitals in England

NHS England have announced that Martha’s Rule is now available in every acute hospital in England.

Since April 2024, Martha’s Rule has been trialled in 143 hospital sites. New data has now revealed that between September 2024 and June 2025, 4,906 calls were made to the Martha’s Rule helplines to escalate concerns, resulting in 241 potentially life-saving interventions.

According to this new data, nearly three quarters of calls (71.9%) came from families seeking help, with 720 calls leading to changes in care, such as the administration of new medications like antibiotics.

Additionally, 794 calls addressed clinical concerns, including delays in medication or investigations, while a further 1,030 calls helped resolve issues related to communication and discharge planning.

NHS league tables launched in an effort to increase standards

The UK Government have announced a new system of quarterly NHS league tables across England in an effort to improve transparency, raise standards and ensure better value for patients and taxpayers.

Under the new system, all NHS trusts will be scored across four performance segments, covering areas such as emergency care, elective procedures, and mental health services.

Top performing trusts will be rewarded with greater autonomy, including the ability to reinvest surplus budgets into frontline improvements such as new diagnostic equipment and hospital upgrades. From next year, with a new wave of Foundation Trusts being introduced, top-performing trusts will also be given more freedom to shape services around local needs.

Meanwhile, underperforming trusts will receive targeted support to drive improvements, with senior leaders held accountable through performance-linked pay.

It is said that patient feedback will also play a central role in how trusts are ranked, and that by summer 2026, the tables will expand to include integrated care boards, and broader NHS performance metrics.

Spending freeze imposed after NHSE identifies £300m budget hole

According to an article by the Health Service Journal (HSJ), the UK Government has imposed a spending freeze across NHS arm’s-length bodies, requiring the NHS to absorb the estimated £300 million cost of July’s resident doctors’ strikes from existing budgets.

The freeze applies to uncommitted spending, with limited exceptions for essential activity such as direct patient care, Spending Review priorities, and critical safety-related operations. Affected organisations include NHS England (NHSE), the Care Quality Commission, NHS Blood and Transplant, and others.

NHSE is also considering fixed pricing for commissioner-funded drugs and incentives for under-spending, while commissioners and providers have been reminded to follow existing spending controls, including recruitment limits and stricter approval for high-cost Continuing Healthcare packages.

The Department of Health and Social Care says the measures aim to cut duplication and protect the NHS from further disruption.

Law Commission recommends changes to disabled children’s social care law

The Law Commission has completed its review of disabled children’s social care law and published its final report.

They have set out dozens of points for the UK Government to consider following a review which has aimed to modernise and simplify the law on disabled children’s social care in England. The commission has sought to better meet the needs of young people and their families and has highlighted some outdated and ‘offensive’ language.

The Law Commission recommends keeping disabled children within Children Act protections while introducing a discrete set of rights and entitlements for disabled children into the Act. It is said that the new, unified legal framework would establish England-wide eligibility criteria, ending the current postcode lottery where a disabled child in one part of the country will have their needs met but a child in another part of the country with identical needs will not.

Children’s commissioner publishes new report setting out how the education system could be reformed

Dame Rachel de Souza, the Children’s Commissioner for England, has published a new report outlining the findings of a survey issued to schools and colleges across England. The report notes some of the significant challenges schools face in meeting children’s needs, explores the factors driving these challenges, and proposes a series of recommendations.

Recognising the fact that the proportion of pupils with EHCPs has continued to grow over recent years, the survey asked schools about the barriers they face to fulfilling an EHCP. Here, it was found that the main barrier for both primary and secondary schools was funding not matching need. A lack of specialist staffing was the second biggest reason.

The report also proposes a series of recommendations ahead of the government’s white paper on education expected later this year. Recommendations include:

  • A national statement of ambition for all children.
  • A new focus on a broader range of additional needs for those who need support inside and outside the classroom.
  • Extra help for schools to deliver targeted and specialist support where needed, and deepen their role, impact and orientation in communities.
  • A new approach to statutory education support: Education, Health and Care Plans.
  • Delivering opportunity locally – Local Opportunity Mission Delivery Boards.
  • The critical role of special schools and alternative provision.
  • Services beyond the school gate.

You can read the full report here.

Northern Ireland

Sinn Féin MLA Danny Baker urges Education Minister to prioritise children with special educational needs

Sinn Féin MLA Danny Baker has urged the Education Minister to prioritise children with special educational needs (SEN), following cross-party support for a motion in the Assembly that highlighted a crisis in the SEN system.

Baker criticised ongoing issues such as inadequate specialist support, long delays, unequal access to services, and poor communication with families, and called for immediate action to deliver real improvements. He also emphasised the need for collaboration with the Health Minister to transform the system.

Baker concluded by stressing that children with SEN must no longer be denied their right to education and a fair start in life.

Scotland

New palliative care strategy launched alongside delivery plan for 2025-28

On 10 September 2025, the Scottish Government launched its new palliative care strategy, ‘Palliative Care Matters for All (2025-30)’, alongside a three-year delivery plan (2025-28).

Through this strategy, the government aims to ensure that by 2030:

  • Adults and children in Scotland have more equitable access to well-coordinated, timely and high-quality palliative care, care around dying and bereavement support based on what matters to them, including support for families and carers.
  • Scotland is a place where people, families and communities can support each other, take action and talk more openly about planning ahead, serious illnesses or health conditions, dying and bereavement.
  • Adults and children have opportunities to plan for future changes in their life, health and care with their families and carers.

These aims are accompanied by eight strategy outcomes, with outcome seven specifically focusing on babies, children and young people. It states:

  • “Babies, children and young people living with serious health conditions, and their families and carers, will experience improved support as their distinctive needs are recognised and addressed by paediatric palliative care, including care around dying, or as they transition into adult services.”

To deliver on the eight strategy outcomes, the delivery plan outlines a total of 23 actions across six different groups. Some of the key actions concerning babies, children and young people include:

  • Building on existing local and national telephone services so that people of all ages, and their families and carers have 24/7 access to support and advice on palliative care.
  • Further developing the national Paediatric Palliative Care Clinical Advisory Service across Scotland so staff providing palliative care for children have 24/7 access to specialist paediatric palliative care telephone advice supported by a consultant.
  • Developing guidance to support improved care transitions for babies, and for young people who have life shortening conditions, including from adult specialist palliative care services, as needed.
  • Developing an agreed Scottish minimum dataset for all paediatric palliative care services that is used to support service commissioning, delivery, monitoring, and reporting.
  • Establishing a strategic collaborative planning group to support commissioning, financial and services planning, delivery and reporting of measurable outcomes data for paediatric palliative care services across Scotland.

It is said that strategy delivery reports will be published on an annual basis to provide updates on progress to implement individual actions. These reports will also include any measurable changes in nationally available data and other relevant measures.

You can access the full strategy and delivery plan here.

Legislative consent memorandum lodged to allow clause 43 of the Terminally Ill Adults (End of Life) Bill to take effect in Scotland

In August, a legislative consent memorandum was lodged by Neil Gray, Cabinet Secretary for Health and Social Care, to allow clause 43 of the Terminally Ill Adults (End of Life) Bill to take effect in Scotland.

Under clause 43 of the bill, the Secretary of State is required to make regulations prohibiting the publication, printing, distribution or designing (anywhere) of advertisements whose purpose or effect is to promote a voluntary assisted dying (VAD) service, and prohibiting causing the publication, printing, distribution or designing of such advertisements.

There is potential that people in Scotland could access the VAD service in England and Wales by taking action to meet its eligibility requirements. As such, clause 43 is seeking to prohibit advertising in Scotland of the assisted dying scheme in England and Wales.

The Scottish Government have therefore recommended that the motion to consent is passed by Scottish Government.

Scottish Health Secretary seeks UK Government view on legislative competence of Assisted Dying Bill

The Cabinet Secretary for Health and Social Care, Neil Gray, has confirmed that a formal request will be made by the Scottish Government to the UK Government to address legislative competency issues surrounding the Assisted Dying for Terminally Ill Adults (Scotland) Bill.

Gray confirmed that discussions with Westminster are ongoing and that proposals are being developed to resolve areas of the Bill that fall outside devolved powers. These include the regulation of health professionals and the specification of the substance used in assisted dying, both of which are reserved matters.

In June, Gray wrote to the Health, Social Care and Sport Committee noting that he had asked the UK Government for its views on what steps it might take to help resolve these issues. He also acknowledged the tight timeline ahead of the May 2026 Holyrood election.

You can read his letter to the Health, Social Care and Sport Committee here.

Wales

Establishment of a Maternity and Neonatal Oversight Panel

In May 2025, the Welsh Government launched a nationally commissioned assurance assessment of maternity and neonatal services to evaluate their safety and quality. This assessment will focus on measuring services against the criteria within the National Quality Statement and Quality Standards to identify areas of good practice and areas of concern.

Earlier in September, the Cabinet Secretary for Health and Care, Jeremy Miles MS announced the appointment of a Maternity and Neonatal Oversight Panel. Made up of experts in healthcare, social care and patient experience, the panel will be a time limited group to provide an independent assessment of Wales maternity and neonatal services.

The panel, chaired by Professor Sally Holland, will begin work in September 2025 and deliver initial advice by 31 December 2025.

The Minister has offered to meet with families once recommendations are made and is open to further statements or questions from Members when the Senedd returns.

You can read more about the panel appointments here.

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