Leaders’ Policy Briefing: Key updates

England and Wales

Changes to thresholds in Charities Act 2011 formalised

On 20 April 2026, regulations updating the financial thresholds in the Charities Act 2011 were signed and laid in parliament, following the publication of the government’s response on 31 October 2025.

The changes, which will come into force on 30 September 2026, enable eligible charities to benefit from reduced accounting and reporting requirements. Some measures, such as revised audit thresholds and the option to prepare receipts and payment accounts threshold will be available to charities for financial years ending on or after 30 September 2026.

Charitable organisations including children’s hospices and other voluntary sector providers are being encouraged to consider whether they can take advantage of these changes when planning accounting and reporting for the current financial year.

A full list of the changes has been set out in the government’s response.

England

Health and Social Care Committee launch call for evidence on the transition from child to adult services

The Health and Social Care Committee has commissioned an independent, politically impartial Expert Panel, chaired by Professor Dame Jane Dacre, to evaluate how effectively health and social care services support young people moving from child to adult provision.

The panel is evaluating 15 statements of intent across six key areas:

• Timeliness and pace of the transition into adult services
• Effectiveness of the transition process and cross-service coordination
• Meaningful involvement of children, young people and their carers
• Workforce and training
• Enabling developmentally appropriate independence
• Promoting equity across the transition

As part of this work, the panel is seeking written evidence from relevant stakeholders, including providers and voluntary sector organisations, to inform its evaluations and subsequent reports to parliament. We have been invited to submit evidence and therefore encourage members to share relevant insights or examples to inform our response. Please send contributions to externalaffairs@togetherforshortlives.org.uk by Wednesday 6 May 2026.

More information about the call for evidence is available here.

Health visitors call for limits on ‘impossible’ caseloads

Health visitors in England are calling for national limits on caseload sizes, warning that some are now responsible for more than 1,000 families each. The Institute of Health Visiting has said that this reflects a workforce that has almost halved over the past decade, leaving staff overstretched and reducing their ability to provide early, preventative support.

have argued that growing caseloads are leading to missed opportunities to identify safeguarding concerns, support parental mental health, and ensure continuity of care. Unlike England, it has been reported that other UK nations operate safer staffing benchmarks of around 250 families per health visitor.

The government has said it is committed to strengthening health visiting services. However, professional bodies have stressed that urgent investment is needed to rebuild and retain the workforce and ensure families receive consistent, proactive support.

Government announces series of measures to help aspiring health professionals from deprived areas

The government has announced a package of measures in an effort to widen access to healthcare careers for young people from disadvantages backgrounds, as part of its 10-Year Health Plan. The reforms aim to tackle inequalities in access to careers such as medicine and nursing, where many students miss out due to a lack of guidance, subject availability and role models in schools serving poorer communities.

Key commitments include the creation of 2,000 new nursing apprenticeships, backed by £65.4 million and targeted at areas with the greatest workforce shortages and highest deprivation. In addition, £15 million is being allocated to expand programmes, helping around 3,000 young people from deprived areas into entry‑level NHS roles and training pathways.

To improve access to medicine, a further 2,000 young people from England’s most deprived areas will be supported over three years to apply to medical school, backed by £2.3 million. Support will include medicine access courses, NHS placements and summer schools to strengthen applications.

The government has also pledged to increase by 50% the number of students who received free school meals entering medical school by 2035, alongside plans to better align medical school places with areas experiencing poor health outcomes. The package also includes a pilot to allow resident doctors from disadvantaged backgrounds to remain in one place for longer, reducing relocation costs and disruption.

Government launches consultation on smoke-free, heated tobacco-free and vape-free places

Earlier this year, on 13 February, the Department of Health and Social Care (DHSC) launched a consultation on proposals to extend smoke‑free, heated tobacco‑free and vape‑free places in England. Forming part of DHSC’s wider ambitions to reduce smoking, prevent illness and protect children and vulnerable groups, the consultation focuses on extending existing restrictions to certain outdoor public spaces and introducing clearer rules on heated tobacco and vaping.

With around one week remaining before the consultation closes, DHSC has re‑shared the consultation and is encouraging palliative care settings to respond, to ensure the proposals reflect the realities of care environments and minimise unintended consequences.

The consultation closes at 11.59pm on Thursday 8 May 2026. Responses can be submitted via the online consultation form available here.

Renewed Women’s Health Strategy launched

The government has launched a renewed Women’s Health Strategy, setting out how it plans to improve women’s health and healthcare over the next 10 years. The strategy focuses on tackling health inequalities, improving access to services, strengthening prevention, and ensuring women’s voices are better reflected across the health system.

Key parts of the strategy include:

• NHS standards: New care standards for gynaecology, improved pain management, and faster diagnoses for conditions like endometriosis.
• Support for healthier lives: Expanded access to contraception, free emergency contraception, abortion service support, menstrual health education, and strengthened perinatal mental health services.
• Research & innovation: Investment in femtech, clinical research, and mechanism to embed women’s voices in innovation.
• Maternity & neonatal equity: Formation of the National Maternity and Neonatal Taskforce, backed by £900M+ for family hubs, with action plans to tackle disparities in maternal and neonatal outcomes and co-developed preconception care models by 2030.
• Women’s voices: A national partnership launching in 2027 to ensure marginalised women inform policy and service design.

More information including the full strategy can be accessed here.

Details of Experts at Hand and Local Authority SEND Transformation Fund published

The government has published details of the Experts at Hand (EAH) and Local Authority SEND Transformation Fund for 2026/27, providing funding to local authorities in England to improve support for children and young people with special educational needs and disabilities (SEND).

In 2026/27, £429 million will be allocated in the first year of the grant, as part of a wider three‑year package worth £1.8 billion for Experts at Hand, alongside additional SEND transformation funding.

The grant supports two main strands of activity. First, it funds local authorities, working with Integrated Care Boards, to develop a new Experts at Hand offer. This offer gives mainstream early years settings, schools and further education colleges access to specialist education and health expertise they could not commission alone, such as educational psychologists, specialist teachers and health professionals. Second, it supports local authorities with the administrative costs of reviewing SEND services and developing local SEND reform plans.

You can access the full guidance here.

MPs debate proposed SEND reforms in parliament

On 13 April 2026, MPs debated reforms to the SEND system following a debate secured by Gregory Stafford MP, a member of the Health and Social Care Committee.

During the debate, MPs raised concerns about ongoing capacity pressures, including long waiting times for CAMHS and overstretched school staff, which are making early‑intervention reforms difficult to deliver. There was also significant discussion about proposals to replace Education, Health and Care Plans (EHCPs) with Individual Support Plans (ISPs), with MPs warning this could weaken legally enforceable protections and restrict access to tribunals.

Responding to the debate, Minister of State Georgia Gould reaffirmed the government’s commitment to working on SEND reform on a cross‑party basis. She highlighted significant investment in specialist places and wider services, confirmed that EHCPs would continue for children who need them, and emphasised that early intervention and inclusion remain central to the reforms. She also outlined plans for strengthened accountability, including Ofsted oversight, a new independent complaints process, and a full consultation.

You can read the full transcript here.

Northern Ireland

Care Closer to Home: New Neighbourhood Health and Wellbeing Model published

On 31 March 2026, the Department of Health in Northern Ireland published the Neighbourhood Model of Health and Wellbeing, following a public consultation that ran from October to November 2025 and received 183 responses.

The Neighbourhood Model is being developed and introduced in a phased approach:

1. Design Phase September 2025 to January 2026: Agreeing the vision and underpinning principles for NI neighbourhood care and identifying best practices through a call for evidence.
2. Build Phase January to April 2026: Publishing the policy guidelines and results of the call for evidence, establishing a neighbourhood development programme and systems for delivery.
3. Implementation Phase from April 2026: Starting implementation, supporting establishment of the integrated neighbourhood teams and systems for measuring out comes, evaluating, investing, testing and scaling up good practice.

The key features of the model include:

• Multidisciplinary Integrated Neighbourhood Teams comprising GPs, pharmacists, nurses, social care workers, community orgs, and local government.
• A focus on prevention and early support, aiming to reduce unnecessary hospital visits and support independent living, especially for older adults, with improved discharge pathways.
• Local partnerships and community involvement, ensuring services respond to local needs and build on existing voluntary sector efforts

Rollout begins April 2026 with ongoing investment in local infrastructure, development of evaluation and outcome tracking mechanisms, and community engagement as services expand.

More information including the full model is available here.

Scotland

Palliative care emerging as a key issue in party manifestos ahead of Scottish Parliament election

Ahead of the Scottish Parliament election in May 2026, palliative and end of life care has emerged as a key issue across party manifestos. Here, there is a broad cross‑party consensus on the need to improve access to palliative care, address inequalities, and secure a more sustainable funding model for hospices, including fair pay for hospice staff.

Specific proposals vary by party but typically include commitments to minimum standards of care, expanded community services, workforce training, and, in some cases, a legal right to palliative care.

More information on the specific proposals included within each manifesto can be found here.

Wales

Health and Social Care (Wales) Act 2025 comes into force

On 1 April 2026, key provisions of the Health and Social Care (Wales) Act 2025 came into force, introducing significant reforms to health and social care in Wales. As part of the Welsh Government’s wider programme of long‑term system reform, the Act aims to place the rights, wellbeing and voices of children, families and disabled people at the centre of service delivery.

The measures now in force include the removal of profit from the care of looked‑after children, the introduction of new direct payments for NHS continuing healthcare, and strengthened regulatory and accountability arrangements across social care.

You can read more about the measures and implementation progress here.

Together We Support

Demand for our cost of living support rises

Cost of living challenges have been the main reason for families of seriously ill children contacting Together for Short Lives’ Helpline, and we have seen a high number of first-time callers making contact to find out what support we are able to offer.

The expense of hospital stays also continues to see families reaching out to us. For example, just this week we were contacted by two families staying at Bristol Royal Hospital for Children seeking help with food costs.

Families and professionals can call our friendly, accredited helpline team on 0808 8088 100, drop us an email to helpline@togetherforshortlives.org.uk or visit our Family Support Hub at www.togetherforshortlives.org.uk/get-support It’s always there when they need us.

Together we Unite

Please complete our annual children’s hospice funding survey

As part of our plans for Children’s Hospice Week, we plan publish a report setting out the state of children’s hospice funding in 2026. To inform this, please complete our survey to tell us how your organisation has been funded in 2025/26 and what you expect to happen in 2026/27. This includes both charitable and statutory sources of funding.

We would be grateful if our children’s hospice members in Northern Ireland, Scotland and Wales could complete the survey too, so we can achieve a UK-wide analysis that supports our fundraising asks during Children’s Hospice Week.

As with previous years, the information you give us will be vital in informing our work to press for equitable, sustainable and transparent statutory funding for children’s hospices and palliative care providers.

We hope to use what you tell us as further evidence for why the new all-age palliative care modern service framework (MSF) in England must be supported by action that addresses the ongoing lack of equitable and sustainable funding.

In Northern Ireland, Scotland and Wales, we would like to work with you to support your calls for more sustainable funding. Particularly, we would like to support our children’s hospice members in Scotland and Wales with your efforts to engage new parliamentarians following the 2026 elections.

We do understand and appreciate the resource needed to respond to surveys like these. While we acknowledge that this is another questionnaire to complete, the information you provide will be vital in enabling us to work on your behalf in the coming weeks and months. Please do respond if you can, and please make sure the survey is completed by the people in your organisation who are most familiar with your statutory and charitable funding sources.

Please complete the survey by 10am on Tuesday 5 May. A PDF version is available here if you wish to prepare the information before completing the survey.

Thank you in advance for your support. If you have any questions, please do let us know by emailing externalaffairs@togetherforshortlives.org.uk.

Ask your local housing association to sign up to Harry’s Pledge today.

Harry’s Pledge was inspired by Harry Charlesworth, a young boy with spastic quadriplegic cerebral palsy and complex needs. It was created by his mum, Hayley Charlesworth, in partnership with organisations across the housing sector, to improve life chances for disabled people and those who care for them.

The pledge focuses on four key commitments designed to create lasting, meaningful change:

• As employers: committing to flexible, carer‑friendly policies that properly support staff with caring responsibilities
• For parent carers: improving signposting to relevant services and lobbying for meaningful, system‑wide change
• In housing: embedding accessibility‑led design from the very start, not as an afterthought
• For paid carers: supporting qualifications, valuing caring as a profession, and advocating for fair pay and recognition

By encouraging your housing association to sign up, you can help drive a more inclusive, supportive housing sector for disabled people, families, and carers. Click here to sign up.

Together We Campaign

Please invite your MP to attend our APPG event in Children’s Hospice Week

On Tuesday 16 June, the APPG for Children Who Need Palliative Care will host a reception in parliament to celebrate the vital work of children’s hospices, supporting children with serious illness and their families.

At the event, MPs will hear directly from families and receive findings from our latest report examining the state of children’s hospice funding.

We need to ensure as many MPs as possible are in that room. We would therefore be grateful if members could please invite their MP to attend using our online form available here.

We join sector partners in calling for urgent reform following the fall of the Terminally Ill Adults Bill

Alongside Hospice UK, Age UK, Marie Curie and Sue Ryder, we have written to the Secretary of State for Health and Social Care, Wes Streeting, calling for urgent action to reform palliative and end of life care for everyone.

Following the fall of the Terminally Ill Adults (End of Life) Bill, we have emphasised that, regardless of differing views on assisted dying, there is a strong consensus that palliative care must be significantly improved. We have therefore urged the Health Secretary to commit to decisive action on palliative and end of life care through the forthcoming Modern Service Framework.