31 March 2026
The National Programme for Palliative and End of Life Care has welcomed the publication of the Welsh Government’s new national approach to commissioning hospice care in Wales, describing it as a significant step towards a more equitable, sustainable, and person-centred system.
The announcement by the Cabinet Secretary for Health and Social Care sets a clear national direction to address long-standing variation in access, funding, and service provision, while supporting the hospice sector to respond to growing demand and increasing complexity of care.
A programme shaped by evidence, engagement and partnership
The commissioning approach builds on a programme of work initiated by the National Programme for Palliative and End of Life Care, informed by a series of national reviews into palliative and end-of-life care across Wales.
As part of this work, the Programme has undertaken face-to-face visits with each commissioned hospice in Wales, providing dedicated time to hear directly from frontline teams about challenges, risks, and areas of best practice, alongside facilitated sessions with hospices and health boards to develop a shared understanding of challenges and opportunities. Through this engagement, the Programme has gathered rich insight from across Wales.
We heard clearly from the sector that funding is often unpredictable and short-term, commissioning and contracting approaches vary across Wales, access to services is inequitable, and workforce pressures are increasing, alongside a strong call for greater transparency, consistency, and long-term planning. At the same time, we saw strong examples of innovation, partnership working, and high-quality care, demonstrating the vital contribution hospices make to communities across Wales.
Building a national picture to inform change
For the first time, the Programme has worked with partners to baseline palliative and end-of-life care services across Wales, aligned to the new National Service Specification. This has provided a clearer understanding of current service provision and variation, funding arrangements across the system, gaps in access and equity, and workforce and delivery challenges.
This work also reinforces the importance of a whole-system approach to specialist palliative care. While hospices play a critical role, not everyone in Wales has access to a hospice bed. In many areas, specialist palliative care is delivered directly by Health Boards, and in some cases these services have not benefited from the same level of additional investment as the hospice sector. This further underlines the need for a consistent and equitable commissioning approach across all settings.
A collaborative national approach
The commissioning approach has been developed in close partnership with Welsh Government, the NHS Wales Joint Commissioning Committee (JCC), Health Boards, and hospice providers. This collaboration has ensured the guidance reflects both national policy direction and the realities of service delivery.
Alongside the commissioning approach, Welsh Government has announced a £4.3 million stabilisation grant to support hospices with immediate financial pressures, helping to maintain essential services while longer-term reforms are implemented.
Looking ahead – implementation and next steps
With the commissioning approach now published, the focus moves to implementation. The National Programme will lead the next phase of work, including a national population needs assessment to inform future service planning and funding, the development of a core service specification to set consistent expectations across Wales, and the design and delivery of a national implementation plan to support transition.
This will also support the system to move towards more consistent and sustainable contractual arrangements from April 2027. Together, this next phase will ensure that commissioning supports the full specialist palliative care system across hospice, hospital, and community settings.
A shared ambition for Wales
Lynda Kenway, National Strategic Lead for Palliative and End of Life Care, said: “This is a pivotal moment for palliative and end-of-life care in Wales. Through engagement with hospices, health boards and partners, we have listened carefully to both the challenges facing the sector and the opportunities to do things differently.
"While hospices are a vital part of the system, we know not everyone has access to hospice beds, and that specialist palliative care is delivered across a range of settings, often under different funding arrangements. This work is therefore about ensuring equity across the whole system.
This approach provides a clear pathway towards a more equitable and sustainable future, where access to high-quality care is based on need, not geography.
"Our focus now is on working together to deliver this, ensuring that people across Wales receive compassionate, coordinated care when they need it most.”
Supporting better care for people and families
Hospices remain a vital part of the health and care system in Wales, providing specialist, holistic care to people with life-limiting conditions and supporting families at the most difficult times in their lives.
This approach marks an important step towards ensuring that services are equitable and accessible across Wales, care is high-quality and person-centred, funding and commissioning arrangements are sustainable and transparent, and the system is better equipped to meet future demand and increasing complexity.