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Planning and Funding Specialist Palliative Care Provision 2003/04 - 2005/06

  • Last modified date:
    19 March 2008

This document confirms the announcement of a £50m per annum central budget for specialist palliative care from 2003-04 and sets out the purposes for which it is to be used.

  • notifies StHAs and PCTs of their shares of this budget
  • sets out the planning requirements, building on the LDP guidance, and the arrangements for submitting plans to the National Partnership Group for Specialist Palliative Care for approval, so that allocations can be made
  • offers background material to inform local plans
  • provides supporting material to assist completion of investment plans.

The £50m per annum central budget and its purpose

2. Background

The NHS Cancer Plan promised that NHS investment in specialist palliative care would increase by £50m by 2003-04, compared with 2000-01. The increase would be used to tackle inequalities in access to specialist palliative care and to enable the NHS to make a more realistic contribution to the costs of hospices in providing agreed levels of service.

3. Progress towards the £50m commitment has been slow. In July Ministers asked Mike Richards, the National Cancer Director, to bring together a National Partnership Group drawn from the NHS and the voluntary sector (see Annex A for full membership). The Group was asked to develop proposals for a new approach to specialist palliative care planning and funding that would ensure delivery of the £50m commitment and develop a mechanism for long term investment that would command confidence.

4. In November 2002, an in-year non-recurrent allocation of £10m was made, to enable faster progress towards the £50m per annum commitment.

The new £50m per annum central budget

5. On 30 December 2002, Hazel Blears, Parliamentary Under Secretary for Public Health, announced the creation of a new £50m per annum central budget for specialist palliative care. The text of the press release is on the Department's press release database. This will run for the period 2003-04 to 2005-06, with the intention that it will be built into PCT allocations in due course. It is expected that, over time, local health communities will supplement this budget from their own allocations.

6. The £50m p.a. is additional to the increases in specialist palliative care spending that the NHS has already made in 2001-02 and 2002-03. And it will enable the NHS to pick up the recurrent costs of the additional £10m allocated in November. It will mean that the NHS can more than meet the NHS Cancer Plan commitment.

7. Its purpose is to tackle inequalities in access to specialist palliative care and enable a more realistic contribution to the agreed costs of hospices, in line with the NHS Cancer Plan. For this purpose, specialist palliative care includes inpatient beds (including those provided by hospices), home care teams, hospital support teams, Marie Curie (or equivalent) nursing services, outpatient services, and day care, bereavement services, and education for staff beyond the specialist teams.

8. The £50m per annum is a revenue budget, but virement to capital is permitted in line with the usual virement arrangements.

Accessing the £50m budget

9. Annex B sets out shares of the £50m per annum budget by PCT, and aggregated at StHA level (recognising that palliative care will need to be planned and funded for populations larger than an individual PCT).

10. The arrangements for accessing and deploying the budget build on the requirements set out in the Planning and Priorities Framework and Local Delivery Plan (LDP) guidance (www.doh.gov.uk/ldp2003-2006) but include additional elements designed to ensure that all the stakeholders, including voluntary sector partners locally and nationally, have confidence in the arrangements. This includes an important role for the National Partnership Group.

The Planning Requirements

11. The core requirements are:

  • each cancer network should prepare a plan for specialist palliative care, in line with the LDP requirements and the criteria identified by the National Partnership Group (see below). PCTs and StHAs should agree how PCT allocations will be pooled on a network basis, and should identify a lead PCT to whom the pooled allocation for each network will be made. Please notify Timothy Hancox at the Department of Health's Cancer Team (timothy.hancox@doh.gsi.gov.uk) of lead PCTs by 28 February.
  • networks should be in a position to share their plans with their StHA by end February/early March
  • StHAs/DsHSCs should submit plans to the National Partnership Group for approval, by 31 March at the latest
  • the National Partnership Group will aim to approve all plans alongside LDPs as soon as possible, and allocations will be made as soon as plans are approved.

12. The Partnership Group's involvement is designed to ensure a transparent process, enabling all partners locally and nationally to have confidence that the £50m commitment will be met in full, that the funding will be committed for its intended purpose, and that the funding increase will yield the maximum benefit for patients. The aim is to foster stronger partnership working at all levels.

13. The Partnership Group will want to satisfy itself that the specialist palliative care plans meet the PPF and LDP requirements, and follow the aims and principles that the Group has developed (attached at Annex C). The Group recognises that time is tight and detailed work will continue beyond March. However, in its March assessment of the plans, the Group will want to be satisfied that

  • the local planning process has been inclusive and transparent and all organisations providing specialist palliative care to the network population have been consulted
  • the plan takes account of the draft NICE guidance and standards for palliative care when available (see www.nice.org.uk)
  • the plan addresses inequity in access to services, and the need for a more realistic NHS contribution to the costs of hospices in providing agreed levels of service
  • the plan picks up recurrent costs as necessary from the 2002-03 £10m allocation, from NOF funded palliative care projects and from the training programme to strengthen district nursing expertise in palliative care, so that partner organisations can have confidence of sustained support for agreed developments
  • local plans have also addressed relevant capital issues, including agreed NHS funding consequentials from voluntary sector developments, including VAT consequentials where relevant, for 2003 and beyond. This is particularly pertinent to any planned and agreed capital developments for palliative care and other cancer services that are being funded by Macmillan Cancer Relief.

14. Progress will be monitored through the arrangements for LDPs overall, and the National Partnership Group will be kept informed of progress. In addition, it will be important that cancer networks keep all their local stakeholders informed of progress. Over time, we envisage a diminishing role for the National Partnership Group, with growing reliance on the local partnership arrangements.

Information to support the planning process

15. The National Partnership Group will explore what supporting material can be made available to assist networks with their planning.

Further information can be obtained from:

Sue Hawkett (020 7972 4836) sue.hawkett@doh.gsi.gov.uk

Robert Freeman (092 7972 3958) robert.freeman@doh.gsi.gov.uk

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