Leaders’ Policy Briefing: Key updates

England, Scotland and Wales

UK Government extends Warm Home Discount

The UK Government has confirmed the continuation of the Warm Home Discount, with eligible households continuing to receive the £150 rebate on their energy bills every winter until 2030/31.

Reforms to the way the scheme is administered also means eligible households in Scotland will receive the rebate automatically next winter, instead of having to get in touch with their supplier to apply for it. Around 345,000 families in Scotland are set to receive the £150 rebate automatically next winter – an increase of around 250,000.

The continuation of this scheme is on top of the average £150 of costs being taken off households’ energy bills from April, through measures announced at the Budget in November.

England and Wales

Agenda for Change pay scales published

The government has confirmed the 2026/27 pay award for NHS staff on Agenda for Change. The uplift will see around 1.5 million NHS staff in England, from nurses and midwives to physios and porters, get a 3.3% pay rise, which will be reflected in April salaries.

The Welsh Government are said to have also accepted the independent pay review body’s (PRB) recommendations meaning NHS staff in Wales will also get a 3.3% pay rise in the next financial year.

Alongside the uplift, the Department of Health and Social Care (DHSC) will begin rapid negotiations with trade unions and employers through the NHS Staff Council to agree funded improvements to the pay structure. This follows earlier work on potential multiyear pay arrangements and is backed by additional funding provided after the 2025/26 PRB recommendations.

Once agreed, these reforms will offer additional backdated pay increases from 1 April 2026, with priorities including:

• Raising pay for the lowest pay bands
• Improving pay for graduates across NHS professions

You can view the pay scales for 2026/27 here.

England

Government accepts many conclusions of Independent Expert Panel’s report on palliative care services in England

The government has responded to the Health and Social Care Committee’s Expert Panel evaluation, setting out its plans to improve palliative and end of life care in England. Central to the response is the development of the palliative and end of life care Modern Service Framework (MSF), which the government has indicated will be a ‘live’ document aimed at driving sustained improvement.

The response is structured around the five focus areas identified by the Committee:

Commissioning: The government partially accepts the Committee’s findings, acknowledging that there is unwarranted variation in access and quality, but claims that some variation in service is expected. The government emphasises the role the MSF will play in providing further support to commissioners.

Delivery of palliative and end of life care: The government accepts the Committee’s findings, recognising the significant pressures facing services in all settings, and that demand is projected to rise in the coming years. The government states this will be taken into account when developing the MSF, which will prioritise moving care out of hospitals and improving early identification, 24/7 community support and integrated generalist/specialist teams.

Shifting to community-based provision: The government accepts the Committee’s findings and emphasises that integrated palliative and end of life care is essential to shifting services into the community. The government claims the MSF will support this shift by improving digital information‑sharing through Shared Care Records, the Single Patient Record, and the NHS App.

Workforce, education and skills: The government partially accepts the Committee’s findings, recognising that workforce shortages continue to challenge the delivery of high-quality end of life care. The government states that a new NHS workforce plan will be published in the spring and will ensure staff have the right skills and are deployed where they are needed most, supported by multidisciplinary teams across health and social care.

Inequalities and inequities in access: The government accepts the Committee’s findings, acknowledging persistent inequalities in access to palliative and end of life care, particularly for people in rural or deprived areas, those with non‑malignant conditions, and people from ethnically diverse communities. Alongside NHS England’s statutory guidance and key tools, the government says the MSF will aim to reduce this variation.

You can access the full response here.

UK Government launches all-age National Cancer Plan

The Government has launched an all-age National Cancer Plan, setting out measures to secure faster diagnoses, quicker access to treatment, and improved support to help people live well with cancer.

Importantly, the plan references the role that the palliative care Modern Service Framework (MSF) will play in delivering better outcomes for people with cancer at the end of life and reducing unwarranted variation. It also includes a commitment to ensuring that children and young people with cancer who need palliative and end of life care receive timely, holistic and personalised support with access to specialist level palliative care when needed.

Other key commitments made in the plan relevant to children and young people include:

• Embed children’s needs in neighbourhood health services: Ensure children and young people are prioritised in new neighbourhood health models, including appointing lead paediatricians in multidisciplinary teams and improving access to evidence-based guidance for primary care.
• Improve access to specialist advice in primary and emergency care: Guarantee that clinicians can quickly access consultant paediatricians for advice or referral when cancer is suspected, reducing delays and variation in care.
• Speed up diagnostic access: Ensure all imaging for suspected cancer in children is reviewed by a paediatric radiologist and improve access to appropriate community-based diagnostic services.
• Use AI decision-support tools safely: Develop and prioritise AI tools in primary care that reflect paediatric-specific cancer guidance, with appropriate safeguards.
• Introduce a new travel fund for families: Provide up to £10 million per year to cover travel costs for all children and young people with cancer and their families, reducing financial strain.
• Improve hospital food for young patients: Review and enhance NHS food standards to ensure children and young people have access to nutritious, child-friendly food during hospital stays
• Enhance the hospital experience: Promote best practice in therapeutic play, youth support coordination, and age-appropriate emotional and practical support during hospital treatment.
• Standardise psychosocial and long-term support: Ensure consistent access to psychological support from diagnosis through long-term follow-up, introduce surveillance standards for second cancers, provide neurorehabilitation keyworkers for CNS tumour patients, and improve access to specialist palliative care.
• Strengthen genomic services: Establish a national network of inherited cancer predisposition services, streamline genomic pathways, and improve surveillance and support following genetic diagnoses.
• Coordinate national research priorities: Create a collaborative national approach to children’s cancer research to reduce duplication, address gaps, and align funding priorities.
• Improve access to clinical trials: Address barriers preventing children and young people—especially 16–24-year-olds—from accessing clinical trials, including workforce, regulatory and licensing challenges.
• Improve data collection and long-term evidence: Enhance national data collection and publication across the cancer pathway, including diagnostic intervals and long-term survivorship outcomes.

You can read our reaction to the National Cancer Plan here.

New measures for the nursing workforce announced

The publication of the Agenda for Change pay scales follows the government’s earlier announcement of a series of measures to help transform the nursing profession and improve pay and support.

In a written ministerial statement by the Secretary of State for Health and Social Care, Wes Streeting, the government has committed to investing in the NHS nursing workforce in four ways:

1. Asking the NHS Staff Council to prioritise graduate pay in upcoming discussions on pay structure reform.
2. Reviewing the work done of every band 5 nurse to ensure job descriptions and pay bands reflect the work that nurses are being asked to do, with additional national funding being made available to support the review process and any resulting salary uplifts.
3. Establishing a single national nursing preceptorship as part of the upcoming professional strategy for nursing.
4. Reviewing the evidence that is gathered as part of the review of band 5 nursing roles to determine whether any further action is required.

You can read the full written statement here.

Hospital trusts receiving 18% more than they should under block contracts

A national NHS review has found that some hospital trusts may be receiving up to 18% more than they should for emergency care under current block contracts.

The ‘deconstruct the blocks’ exercise, commissioned by NHS England but yet to be published, has compared what trusts currently receive through fixed non-elective contracts with what they would get under activity-based national tariff rates.

Data shared with and published by the Health Service Journal (HSJ) from a small number of integrated care boards (ICBs) has revealed that four out of ten trusts reviewed were being overpaid by at least five per cent, with some gaps worth tens of millions of pounds a year. One trust was underpaid by 11%.

NHS England has argued that block contracts have distorted productivity and activity data, but reductions are being capped at 2.5% a year to avoid destabilising services. Some trusts warn the changes pose significant financial risks, while others say they stand to gain large sums if funding reflects actual activity.

Government announces major reforms to SEND support

Today the government has published its Schools White Paper, reforming the way in which children and young people in England with special educational needs and disabilities (SEND) access assessments, plans and services across education, health and social care.

The paper outlines several major changes, including mandatory reassessments for all children with Education, Health and Care Plans (EHCPs), reforms to statutory plans, major investment, and a redesigned system of support.

Some of the key changes proposed include:

A new legal framework for mainstream support  

• Across all mainstream settings, there will be a universal offer setting baseline expectations for inclusion.
• The universal offer will include inclusive environments, accessible and enriching provision, and evidence-based support prioritising early intervention.
• An additional £1.6 billion is being invested in an inclusive Mainstream Fund over three years from 2026/27 to help settings meet these duties.

The introduction of three tiers of support 

Three tiers of support will be established, including:

• Targeted: For those with ongoing needs not met by the Universal Offer. Support may include small group interventions, language development work, or pre-teaching. Each child will have their needs recorded in a digital Individual Support Plan (ISP).
• Targeted plus: For children who require more specialist input to remain in mainstream education. This includes access to the Experts at Hand programme, enabling settings to draw on specialist education and health professionals. Children at this level also have an ISP and may access an Inclusion Base within their school.
• Specialist: For children with the most complex needs. Mainstream and specialist settings will work together to deliver support based on new Specialist Provision Packages. In future, only children requiring these Packages will receive an Education, Health and Care Plan (EHCP).

There will be a clearer set of criteria for when children access each level of support.

Introduction of Individual Support Plans (ISPs)  

• Settings will have a statutory duty to record and monitor special educational needs and provision in an Individual Support Plan (ISP) for children and young people with SEND.
• ISPs will be digital documents that evolve as a child’s needs change, and standardised across all settings to facilitate transitions.

Education, Health and Care Plans (EHCPs) 

• In the future, it is proposed that EHCPs will guarantee the provision from the Specialist Provision Packages for children and young people with the most complex needs and clearly articulate the outcomes they should expect to achieve.
• If a child or young person is assessed as not requiring an EHCP, then the local authority will be expected to work with the setting to ensure appropriate support is put in place.
• From September 2029, there will be mandatory EHCP reassessments at key transition points — primary to secondary, and secondary to college or further education.
• A fast track route for a specialist provision package and EHCP for children under 5 who have been identified as having complex needs will be introduced – DfE and DHSC will work with NHS England to enable better information sharing between health professionals and local authorities.

Inclusion Bases:  

Inclusion Bases’ will replace the current terms SEN unit, resourced provision and pupil support unit, and instead comprise of two models:

• Support Bases (setting/MAT funded, providing Targeted Support
• Specialist Bases (LA funded, providing specialist support)

High needs capital investment worth £3.7 billion is being provided between 2025 and 2024 to create tens of thousands of new places in Inclusion Bases in mainstream settings, make buildings accessible and create new special school places.

Inclusion Strategy:  

• Settings will be required to publish an Inclusion Strategy setting out how resources are used to benefit children with SEND, this will replace the current duty to produce SEN Information Reports.
• They will also be legally required to publish this Inclusion Strategy annually, so parents and local partners can understand how inclusion is being delivered.
• Inclusion will be embedded in Ofsted inspections and national data.

Educational psychologists, speech and language therapists and training 

• An investment of £40 million over three years is being provided to boost the educational psychology and speech and language therapy (SaLT) workforce.
• Investment will be made to train over 200 more educational psychologists per year from 2026 and 2027, with further investment to train more over the following three years.
• The Department for Education, in partnership with the Department of Health and Social Care (DHSC) and NHS England, will work to ensure that there is a new SaLT advanced practitioner in every Integrated Care Board (ICB) area.
• From September 2026, a new training package of over £200 million over three years will be available to all staff working across early years, schools and Post-16 settings to support staff to build inclusive learning environments.

Changes to the SEND Code of Practice:  

The government has suggested updating the Code of Practice to:

• Clarify responsibilities for education, health and care partners.
• Ensure faster access to support without waiting for medical diagnosis.
• Provide guidance on mental health support.

Accountability: 

The government has pledged to improve accountability across the SEND system. Key proposed changes include:

• Duties on settings to produce inclusion strategies and ensure every child and young person receives timely, high-quality and effective support.
• A statutory duty on settings to record and monitor special educational needs and provision in an Individual Support Plan (ISP) for children and young people with SEND.
• Duties on local authorities to ensure sufficient provision, apply national Specialist Provision Packages, and deliver timely, lawful assessments.
• Making integrated care boards (ICBs) formally accountable for identifying and securing required health provision, with joint Ofsted/CQC inspections testing this.
• An increase in national oversight with an independent expert panel reviewing national standards and provision packages, and the Children’s Commissioner getting a new statutory role monitoring delivery.

The consultation can be accessed here, and will close at 11:59 on 18th May 2026.

Government announces £5 billion to write off local council SEND deficits

The government has published its Local Government Finance Settlement for 2026/27-2028/29. In the statement, the Minister for Local Government and Homelessness, Alison McGovern, announced that the government will introduce grants to cover 90% of eligible local authorities’ Dedicated Schools Grant (DSG) High Needs deficits accrued to the end of 2025-26. This is projected to be worth over £5 billion.

This grant will be paid in Autumn 2026 and will be subject to each local authority submitting and securing the Department for Education’s approval of a local SEND reform plan.

For any deficits accrued from April 2026 to April 2028, the government has said that it will set out further details on how it will deal with these in the upcoming Schools White Paper, which is expected before the end of the month.

The statement from Minister McGovern also confirms that from 2028/29, SEND spending will be covered within the government’s DEL budget meaning local authorities will not be expected to fund future SEND costs from general funds.

You can read the full statement here.

Additional funding for disabled young adults to tackle the cost of living crisis

The government has announced new financial support for disabled adults, including young adults aged 18-24, receiving social care, alongside investment in home adaptations to help people live independently.

From April 2026, the minimum income guarantee for working age adults receiving home care will rise by 7%. This equates to approximately £400 more a year, with those receiving the disability premium keeping up to £510 more.

The government has also confirmed £723 million for the Disabled Facilities Grant next year, helping disabled adults adapt their homes. According to the government, the grant supported 60,000 people last year and helps to prevent hospital admissions and speed up discharges.

Thousands of children facing long waits for community health services

According to an article published by the BBC at the end of January, 300,000 children in England are waiting for NHS community services such as speech and language therapy, hearing services and disability support. Of these 300,000, approximately a quarter (26%) are waiting for more than a year. When compared to adult community health services, only approximately 1% of adults have to wait this long.

The article warns that community waits for under 18s have got worse over the last three years. Since early 2023, year-long waits have risen six-fold to the point more than 77,500 children are now in that position.

These delays are being described as catastrophic with many concerns that they could harm children’s development. As such, Elliot Howard-Jones (Chair of the Robinson Group which represents specialist community NHS services) has called for the same level of national focus and investment as the hospital backlog has received.

You can read the full article here.

Parliamentary committees launch inquiry into children and young people’s mental health

The House of Commons Education Committee and Health and Social Care Committee have launched a joint inquiry into the mental health of children and young people. The inquiry will examine the support available in education and community settings for those up to the age of 25, as well as how well those services integrate with specialist Child and Adolescent Mental Health Services (CAMHS), acute and other statutory NHS services.

Specifically, the inquiry will explore the relationship between children and young people’s mental health and wellbeing, the support that is available to them and how well they are able to thrive and succeed in education. There will be a particular focus on children with special educational needs and disabilities (SEND), care experienced children and young people and others who have suffered adverse childhood experiences.

To gather insights, a call for evidence has been launched and will remain open until 23:59pm on 27 March 2026. The committees will also shortly launch a survey to gather anonymised personal experiences from individuals. More information about the survey will be shared soon.

You can find more information and respond to the call for evidence here.

Government announces funding for young people’s mental health services

The government has announced a £7 million investment to expand 24 early support hubs across England, enabling them to deliver 10,000 additional mental health and wellbeing interventions over the next year. The hubs provide open-access, drop-in support for 11–25yearolds without the need for a referral, and are designed to help prevent conditions from escalating.

The government has said that findings from the early support hubs programme will shape plans for the rollout of young futures hubs, informing how open-access mental health care is delivered in the future.

This investment sits alongside wider measures including an additional £688 million for mental health services this year, recruitment of thousands of new mental health workers, and the rollout of Mental Health Support Teams in schools and colleges.

Northern Ireland

Health Minister reaffirms commitment to on-time pay settlement for Health and Social Care staff

Northern Ireland Health Minister, Mike Nesbitt, has reaffirmed his commitment to delivering an on-time pay award for Health and Social Care (HSC) staff for 2026/27. This follows the NHS Pay Review Body’s recommendation of a 3.3% uplift for all Agenda for Change pay points from 1 April 2026, which England and Wales have agreed to.

The Minister stated his intention for Northern Ireland is to proceed on the same basis. He also reaffirmed his commitment to progressing towards HSC becoming a Real Living Wage employer.

While Nesbitt stressed that this remains dependent on final budget clarity, he has instructed officials to continue preparatory work at pace.

You can read the full statement here.

Communities minister launches Warm Healthy Homes Strategy for Northern Ireland

The Department for Communities Minister has announced the launch of the Warm Healthy Homes Strategy 2026-2036 this month. The strategy sets out a 10-year framework to tackle fuel poverty and improve energy wellbeing across Northern Ireland.

The strategy focuses on three key themes:

1. Making homes more energy efficient: raising housing standards and investing in retrofit measures for low-income, vulnerable households.
2. Protecting consumers: ensuring affordability, robust protections, and quality standards for energy efficiency and heating measures.
3. Building capacity through collaboration: improving access to trusted advice and support through partnerships and community engagement.

Delivery will be underpinned by:

• Annual progress reports and a Ministerial Statement on fuel poverty.
• A new Fuel Poverty Advisory Panel.
• Enhanced monitoring using a basket of indicators on health, energy costs, and housing conditions.

You can read the full strategy here.

Scotland

Carers to help shape local services

Unpaid carers, disabled people and individuals with lived experience of social care will soon have a direct say in how local services are designed and delivered, following new regulations approved by the Scottish Parliament.

Social Care Minister, Tom Arthur, has tabled an order giving service users and third sector organisations a vote during integration joint board decision making. Until now, only NHS and council-appointed members were able to vote. The change is designed to ensure that the voices of people who rely on services, including those needing community based care to live independently, carry equal weight in decision-making based care to live independently, carry equal weight in decision making.

The draft regulations are set to take effect in September, following the completion of parliamentary scrutiny by the Health, Social Care and Sport Committee.

Wales

Welsh Government launches consultation on national strategy for unpaid carers

The Welsh Government has launched a consultation on a new National Strategy for Unpaid Carers. The draft strategy sets out eight key priorities to improve recognition, rights and support for unpaid carers across Wales:

• Recognition and awareness: Increase public and professional recognition of unpaid carers through accessible information, targeted outreach to Black, Asian and minority ethnic people and other marginalised groups, and e-learning for people in a range of professional roles.
• Access to services: Ensure unpaid carers understand their rights and, where appropriate, receive timely, quality assessments of their needs and support plans.
• Young carers: Promote recognition and support for young carers within education and community settings, including access to identity cards. Regular assessments to ensure they are not taking on too much. Promotion of improved mental health and educational experience and outcomes.
• Financial hardship: Provide unpaid carers with information to maximise income and promote benefit uptake.
• Paid employment: Support for unpaid carers to remain in, or return to, paid employment via promotion of employment rights, carer-friendly workplaces and inclusive employment pathways for carers.
• Replacement care (respite) and breaks from caring: Improve access to suitable respite options, including short breaks, working with local authorities to identify gaps and co-produce improvements with unpaid carers.
• Mental health and wellbeing: Enhance carers’ mental health support through local review of support groups, carer-informed generic services, and increased professional awareness.
• Carers and care planning: Recognise unpaid carers as partners with local authorities and health boards in the assessment, care planning, and hospital discharge for those they care for.

The new strategy will replace the 2021 version and is expected to be finalised following the Senedd elections in May.

The consultation is open until 13 April 2026, and responses can be submitted via the online form here.

Together We Campaign:

Engaging with the development of the Modern Service Framework for palliative and end of life care

Following on from call for evidence on the proposed service interventions in January, NHS England has now advised that while the NIHR Policy Research Unit (PRU) is continuing to analyse and synthesise the submissions, the four highest-confidence interventions based on the current evidence base have been identified. These include:

• Increased identification of people with palliative care and end-of-life care needs
• Specialist palliative care provision in all settings
• Integrated, holistic palliative care and end-of-life care delivered in the home
• Out of hours (24/7) access to support

In addition, the PRU is conducting a rapid piece of work on potential metrics for the Modern Service Framework (MSF). So far, this has involved a session specifically focused metrics relevant to babies, children, and young people which we were invited to take part in.

Pressing the government for clarity on how the £80 million for children’s hospices will be allocated

While we understand that a letter detailing the allocations for the £80 million of NHS funding for children’s hospices is still with the National Director at NHS England (NHSE) for sign off, we believe this is now well overdue and clarity on the allocations is needed urgently.

As such, we have worked with several MPs whom we have warm relationships with, across the political spectrum, to table written questions pressing the government to clarify the individual allocations as a matter of urgency. We are also continuing to engage with officials at NHSE who have reassured us that they too are actively pursuing the issue and pressing for the letter to be released.