Compassionate care for all - adult community specialist palliative care review programme 
Update
09 July 2025
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Independent report published following public consultation on adult community specialist palliative care in north west London

NHS North West London has today published an independent report analysing feedback from a public consultation on two proposed options to improve adult community specialist palliative and end-of-life care across the region.

The consultation, carried out by NHS North West London earlier this year, asked residents, carers, clinicians, and community organisations for their views on two possible options for future service delivery. The proposals aim to ensure high-quality, compassionate care is available to more people, closer to home, and in line with what matters most to patients and families.

Third Sector Together (3ST), a partnership of voluntary and community sector organisations, was commissioned to carry out the independent analysis of consultation responses. Their report provides a detailed summary of the feedback received and the key themes raised by local people, particularly around access, quality, equity, and the importance of culturally appropriate care.  The two options consulted on were:

  • Option A (preferred option): Fully implement the proposed model of care, including 46 new enhanced end-of-life care beds across North West London, while maintaining the current number of existing hospice beds. The Pembridge Palliative Care Inpatient Unit would not reopen. This option would be quicker and easier to deliver and would benefit more people across the region overall.
  • Option B: Fully implement the proposed model, including the 46 new enhanced end-of-life care beds, and reopen the Pembridge Palliative Care Inpatient Unit. To do this, there would need to be a reduction in hospice beds elsewhere, and delivery would take longer due to the need to recruit specialist palliative care consultants and 35 additional staff.
Following an independent review of the consultation feedback, 3ST concluded that on balance, Option A was the preferred choice of the majority. Many respondents supported the broader benefits of Option A, particularly its potential to reach more people, improve equity across the eight boroughs, and strengthen community-based care. Support for Option B was strongest in inner boroughs where some expressed support for the reopening of the Pembridge inpatient unit.

NHS North West London would like to thank 3ST for their high-quality, independent analysis, and all those who took part in the consultation, especially individuals who shared personal experiences of end-of-life care. The findings will play a central role in shaping the final decision on the future model of care, helping ensure that services are equitable, responsive, and built around the needs of our diverse communities.
Decision-making business case to be presented at NHS North West London Board meeting in public

The decision-making business case for the Adult Community Specialist Palliative Care (CSPC) new model of care will be presented at the upcoming NHS North West London Board meeting in public. This meeting will be held on the afternoon of Wednesday 23 July 2025, from 1:00–4:00pm at the Irish Cultural Centre, 5 Black’s Road, Hammersmith, London W6 9DT.  The meeting will also be livestreamed.

Members of the public are able to submit questions in advance. There will be a 15-minute session at the end of the meeting to address as many pre-submitted questions as possible. Board papers will be published and available seven days before the meeting.

We would like to extend our heartfelt thanks to all local residents and stakeholders whose invaluable support and collaboration have helped us reach this significant stage.
Involving communities in shaping community specialist palliative care

We are pleased to have carried out a wide-ranging and inclusive consultation process to ensure that the voices of local people, professionals, and community organisations helped shape proposals for the future of palliative care in North West London.

More than 3,400 people were consulted through a combination of community drop-ins, public events, targeted meetings, and proactive outreach with voluntary and community sector groups. This included both in-person and online opportunities to take part.

We also heard from people through an online consultation survey, which helped us gather detailed feedback from a broad cross-section of the community.

The feedback received throughout the three years this programme has been running has played a vital role in shaping our understanding of what matters most to people when accessing and receiving palliative care. We are grateful to everyone who took the time to contribute.
Financial analysis

A financial analysis of the two options confirmed that both are deliverable, but Option A is more financially sustainable given the current pressures facing the NHS. The Pre-Consultation Business Case (PCBC) showed Option A costs £27.6 million, while Option B costs £29.7 million, a difference of £2.1 million.

Option A scored higher financially because it requires less additional funding and delivers the full benefits of the new model of care. These include fewer acute bed days due to enhanced end-of-life care beds and reduced hospital admissions by supporting people to die in their place of residence through community services. Option A also allows for faster and more equitable implementation across all boroughs by building on existing financial and workforce arrangements.

Option B, however, requires the extra £2.1 million funding, significant workforce investment, and high capital costs to reopen the Pembridge inpatient unit, which has a history of staffing challenges. It would delay the full rollout of the new model and reduce funding to charitable hospices, which are already facing critical financial pressures both nationally and locally.

In summary, while both options are affordable, Option A provides a more financially viable and timely solution that safeguards the sustainability of essential hospice and community palliative care services.
Update from JHOSC - Constructive discussion and clear recommendations

We attended the North West London Joint Health Overview and Scrutiny Committee (JHOSC) on 1 May 2025 and welcomed the opportunity for a constructive and thoughtful discussion with councillors from across the region.

The Committee raised important points about the potential impact of proposed changes to services, and they made a number of recommendations aimed at ensuring local needs are fully considered as plans move forward.  Key Recommendations from the Committee

  • Borough-Level Strategies: Councillors emphasised the importance of clearly explaining what the agreed strategy means for each individual borough. This will help support transparency and give communities confidence that local priorities are being addressed.
  • Enhanced Care Bed Locations: The Committee recommended that, where possible, new enhanced care beds should be located in places with adequate parking for patients, families and staff, recognising the importance of practical access.
  • Resident Communication: There was a strong call for increased and clearer communication with residents—timely, accessible updates to help reduce uncertainty and keep people informed about what’s changing and why.
  • Consultant Recruitment: Councillors stressed the need to thoroughly explore all recruitment options before making any final decisions about service closures or reconfigurations. They noted that earlier challenges, such as those at Pembridge, underline how critical this is.
  • Travel and Access Inequalities: The Committee highlighted concerns about how changes might affect patients' ability to travel. While the use of a bus service has been discussed, members urged careful consideration of its feasibility and limitations for different groups.

We are grateful to the JHOSC for their ongoing scrutiny and insight, and we will continue to work with partners to take these recommendations into account as plans are developed.
What’s happening now

Initial planning is underway with NHS and hospice partners across four local areas to explore how a new model of care could be implemented. This includes identifying who will deliver different services and where they might be located. Each area has assigned leads or is in the process of confirming them, with initial workshops either held or scheduled between March and May 2025.

Key focus areas in early discussions include assessing local needs, addressing service gaps, and exploring delivery options. Once the consultation outcome is finalised (expected July 2025), a detailed appraisal of options and tailored implementation plans will be developed.

A specific example is Central London Community Healthcare NHS Trust showing interest in providing enhanced end-of-life care beds for the Tri-Borough from existing NHS facilities. The high-level timeline is:

  • March–July 2025: Initial workshops and pre-planning.
  • July 2025: Consultation outcome confirmed and funding decisions made.
  • August–October 2025: Detailed planning and option appraisal.
  • October 2025 onwards: New contracts start and phased service implementation begins.
Developing the enablers

Work is progressing on the five enablers that will underpin delivery of the new model of care. A reducing inequalities working group has been established, and alongside this, a community reference group is in place to guide and support the work on tackling inequalities, bringing in diverse voices and lived experiences.

In terms of digital and data enablers, we are continuing to expand the use of the Universal Care Plan and improving our data collection capabilities. This will allow us to monitor services more effectively and use data to inform continuous improvement.

Work is also underway to bring providers together to deliver the workforce development enabler through a collaborative, pan-north west London approach.