The cost of specialist palliative care in the community: a scoping review

We aim to review the evidence on cost of specialist palliative care delivered in the community in order to improve commissioning of these services.


Published: 05/10/2021

Project status: Ongoing

The project

The purpose of the review is to identify, map and summarise the available evidence on the cost of specialist palliative care (SLPC) services delivered in the community in order to inform commissioning specifications and decisions. 

The Nuffield Trust have been commissioned to undertake this work by NHS England and Improvement.

Why it's important

Specialist level palliative care (SLPC) services are essential to those patients at the end of life for whom regular palliative care services are insufficient – that is, people with complex symptoms or with needs for personalised care.

The current commissioning guidance describes services involving specially-trained clinicians providing personalised advice and guidance to patients and the core teams delivering their day to day care. However, the guidance is implemented differently across the country, and as a result the availability of specialist intervention varies by geography.

The provision of SLPC in the community is especially important as a result of Covid-19, because of the increased numbers of people dying at home, which affects the demand for community-based services.  

In order to ensure the most appropriate and affordable aspects of SLPC services are available to the rising number of people who are dying out of hospital, a review of the costs of SLPC’s core features is needed. This new information will accompany existing service specifications and aims to encourage local commissioners to review the funding for specialist palliative care services to the community.

What we'll do

The objective of the scoping review is to systematically map the existing research literature to answer the research question:

What UK-based evidence is available on the cost of providing specialist palliative care services (in part, or in full) in the community?

Project outputs

The output for this work was a short briefing for commissioners. This summarised the key themes from the available evidence and identified implications for commissioning and research. 

Evidence review for commissioners on the cost of providing specialist level palliative care in the community

Appendix: table summarising the evidence published on the Palliative and End of Life Care Network workspace


The review will be carried out during October to December, with an output expected in early 2022.

Further information

For further information please contact

Our people

  • Senior Fellow
  • Nuffield Trust

Sarah Scobie

  • Acting Director of Research
  • Nuffield Trust
  • Fellow
  • Nuffield Trust