Jim Shannon
MP for Strangford · Democratic Unionist Party · United Kingdom
“I thank the Minister for those answers. This has happened three times in three years. Normally, on the third strike, you are out. Instead, the chief executive gets an £871,000 bonus. For people in Northern Ireland, a flight to Great Britain is a basic utility. When NATS crashed, my constituents were entirely cut off.”
“When it comes to lobbying, Northern Ireland has a peculiar circumstance where one party can be involved in politics in Northern Ireland and at the same time be involved in politics in the Republic of Ireland. When it comes to the accountability that the hon.”
“Member for North East Fife referred to this—everybody knew every officer in the area where they lived. Different times mean different pressures and different needs, but I have always supported community policing in all my years as an elected representative, throughout my time on the council and in the Northern Ireland Assembly before comi…”
“I will say this to the Minister: although policing is a devolved matter for us back home, I want to make some comments, if I may, about the focus of the police, which means they sometimes do what is unnecessary. I will give an example.”
“The hon. Gentleman is a Leicester City supporter, as I am; we do not have to seek our sorrows at this moment in time, but that is by the way. More importantly, his comments underline the issues for local independent pharmacy owners. As the hon.”
“That is the reality for these people, who have consciences, feel compassion and want to care for their patients and customers. The impact is clear, because almost 90% of pharmacies in Northern Ireland were unable to pay their wholesaler bill in January. Think about what that means for a second: that is real pressure.”
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“I believe that we must remain committed to providing high-quality international aid that will contribute to a long-lasting positive change in areas where the persecution of individuals is most targeted. We cannot allow the most vulnerable to be left to suffer, and we cannot turn our backs on injustice. I am always minded of Proverbs 31:8-9—I know you will appreciate this, Sir Desmond, as I do—which states: “Speak up for those who cannot speak for themselves, for the rights of all who are destitute. Speak up and judge fairly; defend the rights of the poor and needy.” There must also be full transparency about how our international aid is being used to promote the fundamental right to freedom of religion or belief, particularly in countries such as Nigeria, Pakistan and Myanmar where so many continue to suffer simply because of their faith.”
“The effect is like a stone hitting water—it ripples the whole way out. Persecuted religious minorities are suffering more than ever without the commitment of permanent, ongoing support. The Government must ensure that their needs are protected and addressed. The UK has long been a leader in championing freedom of religion or belief, and the Government made a good decision by renewing the appointment of a special envoy for freedom of religion or belief—the hon. Member for North Northumberland (David Smith) —in December 2024. To ensure that we are upholding our reputation and protecting the right to religious freedom, we must strongly oppose cuts in the budget that clearly harm the vulnerable individuals that we are striving very hard to protect.”
“Several affected projects involved a focus on freedom of religion or belief, such as Asia and ethnic freedom, or the documentation of religious freedom incidents in Sudan. The NGOs and faith-based humanitarian organisations have now been left with depleted resources, unfinished missions and heartbreaking reports from the field, where support is now absent. That is the effect of the cuts: the staff, volunteers and international partners, who are driven by compassion, conviction and service, now find themselves unable to meet human need because the infrastructure that enabled them to do so has been abruptly dismantled. The termination of USAID has led to a global vacuum in which NGOs struggle to survive, rendering communities such as the Yazidis in Iraq increasingly vulnerable to the termination of psychosocial support and humanitarian aid.”
“It is a reminder that we have not forgotten those facing the most horrific forms of persecution simply because they choose to believe, whether that is the Rohingya population in Myanmar, Christians in the middle east or the Ahmadiyya in Pakistan, all of whom face ongoing violence, forced displacement and deep-rooted discrimination. The devastating effects of global cuts to international aid have been evidenced most clearly in the decision to dissolve USAID. In January 2025, thousands of humanitarian and international aid projects were put on a 90-day freeze, and over 80% of its projects were permanently terminated. Global organisations such as World Vision and Samaritan’s Purse, which are active in my constituency of Strangford, were directly impacted, as well as Catholic Relief Services.”
“It is a pleasure to serve under your chairship, Sir Desmond. I thank the hon. Member for West Dorset (Edward Morello) for setting the scene so incredibly well. International development aid has been significant in helping at-risk individuals and groups around the globe. As chair of the all-party parliamentary group for international freedom of religion or belief, I acknowledge the importance of providing financial and physical support to religious minorities that are facing threats, violence and persecution on a daily basis. International aid has long served as a lifeline for minority groups to rebuild their lives, to provide additional education and to support local organisations.”
“I commend the hon. Gentleman for securing this debate. I also respect the men and women of Royal Mail but, in my office, one major issue has been delay. For those who are elderly, with sometimes complex and severe health problems, the mail is not arriving in time. They miss their appointments and the follow-up. The fines from Government are not working. What else does the hon. Member think the Government should do to ensure that Royal Mail is accountable to our constituents for the delivery of mail?”
“I look to the Minister—as I always do, because she answers us and listens to our requests—for a commitment to ensuring that our constituents have access to the care that they need, whether it be cross-border or within our healthcare systems in England, Scotland, Wales and Northern Ireland. Furthermore, hon. Members have shared experiences of the medical records issue within our constituencies. When so many people travel to different parts of this nation to study, more must be done to ensure that their records can flow smoothly and without hassle. My goodness, Mr Dowd, a life without hassle—it would be a miracle.”
“I hope that the Minister will forgive me, but it seems illogical not to have a system that takes that on board. One of my staff members who went to Chester to study was in that exact scenario around 10 years ago. She had to travel back to England and pay £50 for a printout of her records to take to her GP back home. We must not forget that £50 was a lot of money for a student 10 years ago. It might be expected that the cost has now gone way beyond that. This debate is really important, so I want to make sure that other hon. Members get their five minutes as well. There are clear examples of where cross-border health initiatives work and are beneficial to supporting people who are faced with extensive waiting lists and serious conditions that alter their day-to-day life.”
“They could have been waiting up to 10 years for that surgery in Northern Ireland if they had not been able to avail themselves of the scheme with the Republic of Ireland. Those are some examples of how strategies like these work; I listened to hon. Members’ examples of similar processes in their constituencies. I want to talk briefly about the importance of medical records. I spoke to the Minister about that beforehand, and others have referred to it. Through working closely with universities, I have witnessed a few examples where a young person lives in Northern Ireland and goes to Scotland or England for university. When they come back to Northern Ireland three or four years later, healthcare professionals cannot access their information as there is no shared provision for medical records.”
“I thank the hon. Member for South Antrim (Robin Swann) for his contribution. He will probably be embarrassed by this, but I want to put on record that he was a great Health Minister when he was in the Northern Ireland Assembly, and I thank him for that. I never heard anyone say a bad word about him—and I talk to plenty of people, by the way—so I would say that he is an example of a Minister who really worked hard. I know of a couple of constituents who availed themselves of the scheme and to say that their surgery was life-changing is an understatement. The hon. Member for South Antrim referred to his son. One of my constituents had a hip replacement and one had knee surgery.”
“I want to talk about a cross-border health scheme that was used in Northern Ireland some years ago before our official exit from the European Union—although it appears that we never exited—and when we were all in the United Kingdom. The scheme meant that patients in Northern Ireland who had been on health and social care waiting lists for two years or more could apply to receive private treatment in the Republic of Ireland and claim reimbursement from the Northern Ireland Department of Health. When I was a member of the Northern Ireland Assembly and in my early years here at Westminster, I saw numerous examples of hip replacements, knee replacements and cataract operations being done down south because the patients had waited two years. The payment for the scheme then came from us in Northern Ireland. There are systems that work.”
“It is a real pleasure to serve under your chairship, Mr Dowd, as always. On behalf of us all, I look forward to your deliberations. I thank the hon. Member for Brecon, Radnor and Cwm Tawe (David Chadwick)—I think I pronounced that right—for securing this debate. [ Interruption. ] Did I get it wrong? My apologies; the Northern Ireland accent gives it away nearly every time. While we are one United Kingdom, it is always important to remember the differences that we have in devolved matters, and in healthcare specifically—especially in Northern Ireland, where we have witnessed major disparities. It is a pleasure to make a contribution on that.”
“I am very much informed by my constituents in Strangford, where local church groups undertake fantastic work to support those in other countries plagued with the likes of malaria, tuberculosis and AIDS. I think specifically of the Ards Elim church in Newtownards in Strangford, which sends groups out every year to support those facing the devastating impact of those diseases. Does the hon. Member agree that more must be done, either by helping to fund their work or working in partnership with them, to ensure that we are doing everything necessary to help them do their bit to help others?”
“I commend the hon. Gentleman for securing this debate. In September, it was alleged that more than 20 HMOs in Northern Ireland did not have appropriate consent. Does he agree that, whether the HMOs are student accommodation, private housing or Home Office housing, there must be planning consent, and planning enforcement must be swift to act on any breach, even if the party breaching planning rules is a Government body? Planning regulations apply to us all equally, without favour.”
“I thank the shadow Secretary of State for bringing this debate forward, and I welcome it. I am always constructive and encouraging, so let me say that Ards and North Down borough council, my local council back home, has a scheme for a new, thriving high street. A council grant enables shop owners to repaint their premises, provide new signage and address the blight of vacant shops. Online shopping without investment means that the high street cannot survive. Does he agree that the Government should extend the initiative that we have back home in Northern Ireland, in my council area, to councils here, to help with jobs and rebuilding the high street?”
“The Minister is a good man, and I mean that sincerely. I think he understands and shares the faith that I have when it comes to looking after those who are less well off. Every day in my office I meet constituents who have disabilities or complex health needs, anxiety and depression or severe mobility issues and people whose health problems are impacting their families. They are burdened with financial pressures. Those who cannot cope with life must not be penalised. Can the Minister reassure us that the vulnerable will not become a target for the Government or indeed anyone in this Chamber?”
“Gentleman agree that we must use any and all methods at our disposal to help those desperately needy and innocent people as a matter of urgency?”
“I commend the hon. Gentleman for securing the debate and for all his work across Africa before coming to this place. I respect him greatly for his desire for human betterment. As the chair of the all-party parliamentary group for international freedom of religion or belief, I have spoken and asked questions about Sudan some 14 times in the past year—as have others—because I am acutely aware of the precarious situation for Christians in the region. Christians have been murdered in the beastliness and wickedness that is happening. Patients and staff have been murdered in hospital. I have consistently asked the Government to step up support for those who are being targeted because of their faith. It grieves me greatly, it grieves the hon. Gentleman greatly, it grieves us all greatly. Does the hon.”
“I thank the Secretary of State for his answers. Reports in the newspapers indicate that 150,000 new Russian soldiers are being prepared for an onslaught in eastern Ukraine. I do not doubt for one second that the Secretary of State, the Labour Government and this Parliament are committed to doing something, but reports seem to indicate that other countries are slowing down on what they give. Has he been able to encourage other countries to ensure that they replicate what we give?”
“Will the Secretary of State send the message today that he will not sign off on the narrative that our troops—the Royal Ulster Constabulary and the Ulster Defence Regiment—were ever anything other than honourable men and women putting their lives on the line for us, and that they will be protected as honourably as they protected us? How does the Secretary of State intend to protect them better than we are doing right now?”
“I will first declare an interest: I served in the Ulster Defence Regiment and the Ulster Royal Artillery for some 14 and a half years. This ruling was expected, as there was no additional evidence and it was twice held to be not fit for prosecution, as others have mentioned. It is hard to understand how they could pursue something without having the criminal investigation and the evidence sorted in advance. It is clear that the Secretary of State must address the way forward and provide certainty for those service personnel who know that they served honourably in impossible conditions, and yet who live with the sword of Damocles hanging over their heads, waiting to have their service used as a tool by republicans to make it seem like they were fighting a dirty war, when quite clearly they were not.”
“You will tell me whether it is or not, Madam Deputy Speaker. In my constituency, a young man was killed in Portavogie today in a knife attack. I think it would be in order to mention that there and perhaps the House would join me in prayers—”
“I commend the Prime Minister and the Government for bringing this Bill forward. I think it heartens us all to see its contents. Does the Prime Minister not agree that, with the rise of social media, there is more public scrutiny than ever before and less trust in our institutions? As he has outlined, the Bill is an opportunity to begin that journey of restoring public trust, but we must be mindful that nothing less than accountability can be acceptable. The public understand that mistakes can be made, but they cannot and should not forget when cover-ups take place.”
“I commend the hon. Lady for bringing this debate forward; I spoke to her beforehand. Does she agree that those leaving care may not have had the financial advice and instruction that they should have had and that many of us take for granted? It is imperative that they are taught how to be self-reliant and are able to manage their finances by themselves. Does she further agree that such classes should also teach these vulnerable young people, who do not have a family to help and protect them, how to protect themselves financially and physically from those who would seek to target them?”
“Member for Winchester (Dr Chambers) agree that a concerted campaign across this great United Kingdom of Great Britain and Northern Ireland to address those issues might be a way forward?”
“I wanted to be here at the beginning, but unfortunately I could not because I had other things to do in the Chamber. I declare an interest—like the hon. Member for South Norfolk (Ben Goldsborough), I am going to get one of mine done very shortly, but in Northern Ireland the wait list is 56 weeks. If it is red-flagged, it is five weeks. There is anxiety and stress for everyone—not for me, but for all the others—because it is not about me but everyone else. Does he agree that the NHS, wherever it may be in this great United Kingdom of Great Britain and Northern Ireland, needs to ensure that those who have melanoma and a biopsy get the urgency that is absolutely critical? The Minister is in her place—there is no better person to answer these questions than her—and I look forward very much to what she says. Does the hon.”
“I welcome the Minister and, indeed, the whole Front-Bench team to their places—well done! On the industrial strategy, what steps have been taken to fund high-quality workforce apprenticeships in sectors such as technology, manufacturing and hospitality, to provide young people with opportunities for employment and lives in those industries? Will the Minister undertake to discuss these matters with the relevant Minister at the Northern Ireland Assembly?”
“I thank the Minister very much for his well-chosen words. I thank the right hon. Member for Oxford East (Anneliese Dodds) for securing this urgent question. Other MPs and I have long been highlighting the atrocities taking place in Sudan, including stomach-churning terrorist attacks, and rapes and murders taking place daily. It grieves me greatly, and I know it grieves this House greatly. I underline the issue for Christians in particular, who are particularly targeted in Sudan. The latest attack is yet another where the detail makes me feel sick to my stomach, yet it is simply an extension of the evil that the world has turned a blind eye to thus far. I know the Minister is honest, so what more will the Government do to deliver the right help and to step up and step in for the people facing that devastation in Sudan?”
“Monday 27 October marked International Religious Freedom Day. In the UK, we are fortunate to enjoy the freedom to believe or not to believe without fear of persecution, but sadly in countries such as Nigeria and Sudan, which was mentioned this morning, many religious minorities continue to suffer appalling daily discrimination and violence. Will the Leader of the House join me in marking that significant day, and urge the Government to reaffirm their commitment to making religious freedom a key foreign policy priority?”
“I thank the Minister for his commitment to finding solutions, and for his incredibly compassionate demeanour in handling these issues. I think we all thank him for that. The streamlined scheme for compensation opened just three weeks ago; can the Minister confirm that it is indeed now easier for people to access the money that they deserve? I hope that the scheme is not adding more worry and stress to those who live their life under a burden not of their making. Are the Government truly sharing the load with them, and what more can the Minister do to make the process smoother?”
“I thank the Chair and the Committee very much for their report, and I think what they are saying is positive. The United States of America, the United Kingdom, the EU and many Arab states have all pushed for peace. They state collectively that Hamas cannot have any part in the future of Palestine, that Hamas is the obstacle, and that Hamas must be disarmed and can never ever be allowed to exist. For a lasting peace to mean something, Hamas has to go. Does the right hon. Lady agree with that?”
“I commend the hon. Lady for securing this important debate—the fact that so many Members are present is an indication of its importance. In my constituency I have seen an increase in the number of people who bought their house or flat many years ago and are now facing difficulties with the level of charges, unexpected cost increases, and poor communication and service quality. Does she agree that a service charge can never be seen as a blank cheque for the owners, and that what those charges are spent on must be itemised and made clear?”
“By 2050, the number of people in need of palliative and end-of-life care in the UK will rise by 147,000 to over 745,000 every year, and that increase will be driven by a growth in the number of people dying over the age of 85. These are really important stats, and we cannot ignore them; indeed, I believe the Minister will be focusing on them. Around 90% of the people who die each year need palliative care, but one in four of them is missing out. Older people, and particularly those with a non-cancer diagnosis, are at risk of missing out on the palliative care they need at the end of life. Research indicates that most people want to receive care at the end of their life and die at home. Elderly people tell me that all the time—they want to be at home.”
“That is unsustainable. A new palliative care strategy for Northern Ireland that takes account of demographic changes and associated requirements for service transformation and investment is urgently needed. That is what is happening in Northern Ireland, and in the mainland, things are very similar. Marie Curie has highlighted that as the population ages, more people will be living with and dying with multiple complex conditions. Every week in my office, when it comes to assisting those of my mum’s generation—and perhaps some of my own—with benefits, I see people with multiple complex needs more than ever. It is not just one thing that people are suffering from, but a multitude of things.”
“He and I are becoming a bit of a tag team, because on three days this week he has been the Minister responding to the debates that I have been involved in. The shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans), has been there as well, so he should not be left out. According to Marie Curie, in the next 25 years in Northern Ireland—I know it is not the Minister’s responsibility, but I want to give the stats, because they are important— there will be 20,500 people requiring this type of care, which is a rise of 32%. That includes a doubling of need by those aged over 85. It is also projected that the number of deaths in the community in Northern Ireland could rise by 74% during that time. Approximately 60% of the cost of care delivered through the independent hospice sector in Northern Ireland is reliant on charity.”
“She always likes to know what happens in this House and I am able to tell her that, but she will also give me her opinion, which I never ignore—indeed, I probably keep to it as much as I can. Those visits to the nursing home, coupled with the focus on assisted dying, have highlighted to me with greater effect the changes that are needed in how we handle our older generation and their needs. I have spoken with representatives of both Sue Ryder and Marie Curie not simply to highlight the difficulties that most of us will be aware of, but to offer some ways that we can improve. I am pleased to see the Under-Secretary of State for Health and Social Care, the hon. Member for Glasgow South West (Dr Ahmed), in his place.”
“I beg to move, That this House has considered the ageing community and end of life care. I thank the Backbench Business Committee for selecting this subject for debate. I declare an interest as the son of Mona Shannon, who is 94 years young and resides in a nursing home near Killyleagh in my constituency. Along with most other middle-aged sons or daughters—in my case, maybe a wee bit more than middle-aged—I am acutely aware that time is marching on and so are my mum’s needs. The wee five-foot-nothing lady who kept three six-foot sons under control is no longer to live alone, but she is as sharp as a tack and I am thankful for the wisdom she gives me when I visit her twice weekly. Indeed, I suspect that every Friday and every Sunday I get a wee bit of wisdom—and maybe a wee bit of a telling off.”
“I hope the Minister will be able to provide assurance on this, because that is what Marie Curie wants, it is what Sue Ryder wants, and it is what every mum, dad and family member wants as well.”
“Access to a 24/7 palliative care advice and support telephone line has been recommended as a minimum service requirement for nearly two decades, but research shows that very little has happened, which underlines the issue that the right hon. Member for New Forest East (Sir Julian Lewis) raised. Only seven of the 42 integrated care boards in England said they have a dedicated 24/7 single point of access to palliative and end-of-life care advice, guidance and onward referral to other services, when needed—those are all important factors. Despite the introduction of a new legal duty for ICBs to commission palliative care services in the Health and Care Act 2022, the urgency and importance of ensuring that everyone has the best possible care and support at the end of life has yet to be recognised as a national priority.”
“I thank the right hon. Member for his intervention and for the wisdom that he brings to all the debates he participates in. The Minister is listening, and he is a good Minister, so I know he will come back with the response we hope to have. How often have we listened to family members who are past themselves with exhaustion and guilt about how they are caring for their loved one and who feel unprepared and yet unwilling to let them go into nursing care? With more support, their lives would be easier and their loved one’s life happier. This knowledge is why I was not surprised to learn that almost £12 billion of public funds was spent on healthcare for people in their last year of life, 81% of which was spent in hospital, with only 11% spent on primary and community care.”
“I understand that the Minister has a copy of my notes, and my seven points will be in there. To realise the 10-year plan objectives, which I have clearly said I support and want to see happen as soon as possible, palliative and end-of-life care must be recognised as a vital part of our health and social care system. Without making palliative and end-of-life care a priority for health reform, the Government will not achieve their bold ambition to provide more care in the community. I want the Government to achieve that ambition.”
“The hon. Member is absolutely right. Politics aside, I want the Minister and the Government to do the job. It does not matter who the politician or the political party is; let us just give our people some hope. That is what I wish to see come out of this. What assessment have the Government made of the need for a national strategy for palliative and end-of-life care? How will the Government ensure that palliative care specialists are included in neighbourhood health centres? What progress are the Government making on ensuring that every person with palliative care needs in the UK has access to a 24/7 support and advice line? I believe that we can find a route towards an acceptable standard of life not simply for those who can afford private healthcare, but for all in our ageing communities.”
“But we cannot do it without Government buy-in, or without help from the Minister, and from the Labour Government and those in power. The hospice sector is looking for a way to do things better, so I ask the Minister to join those who know this issue inside out, and find a route to help our ageing community and those in end-of-life care. That is also from Marie Curie, Sue Ryder and Professor Dhesi—all those people, and all of us as MPs on behalf our constituents. Thank you for your time, Minister, and I look forward to your response.”
“We must ensure that there is information, and above all funding to deal with the growing pressure—the family issue that the hon. Member for Carlisle referred to—because how we treat the most vulnerable in our society is the measure that we will all be judged by. I am no better than anybody else, but as elected representatives you and I, Madam Deputy Speaker, and everyone in the Chamber want to do the best for our people. Today we ask for the best for our people. I work alongside my mum to ensure that her last time on earth is the best we can make it, and I know I can safely say that it is the desire of this House and the Minister to provide that for every person in the United Kingdom of Great Britain and Northern Ireland.”
“It is about expanding care in the community through partnerships, virtual wards, and increased hospice-at-home services to help more people die at home and reduce emergency admissions. We must aim to make full use of hospices’ expertise and space to support people with complex multi-morbidities and those in the last 1,000 days of life, preventing emergency admissions and helping people to live well. I will keep to your timescale, Madam Deputy Speaker; I am coming to the end. The end of life is not a happy topic, but I believe it is a necessary conversation. We must open that conversation to ensure that people feel able to record their wishes for the end of life, so that more of their needs are met by the people involved in their care.”
“The envisaged ecosystem would absorb patients from across the acute setting and increase referrals to community settings, helping our wonderful NHS to use its bed capacity more effectively, and relieving strain on the discharge system. The Sue Ryder model will shift care into the community by increasing hospice-at-home services and virtual wards, funded in line with national currencies and fast-track CHC reform. It is believed that this new approach to hospital care will develop dedicated care, alongside suites on NHS sites to provide compassionate, tailored care for those approaching the end of life, and to relieve pressure on hospital teams. We must increase support for people in their own homes—that is what I want, what the hon. Member for Carlisle (Ms Minns) wants, and probably what we are all seeking.”
“Professor Jugdeep Dhesi, president of the British Geriatrics Society, said: “Everyone should have access to high quality care until the end of their life, including palliative and end of life care when they need it. Sadly, this is not the case for many older people across the United Kingdom.” Sue Ryder also asked me to highlight some issues. It is working to create a new ecosystem around palliative and end-of-life care, and to unlock hospital productivity through swiftly shifting care to the community in a progressive way that is sensitive to the resources available across the wider system, and focused on genuine collaboration at a local, place, and system level.”
“All of these stats can become figures on a page, but when I read them I think of the wee mummy lying on her bathroom floor after a fall, all night in tears; I think of my constituents who sob in my office, begging for help with their dying parent; I think of carers who are run ragged and know that a 15-minute call with that elderly person cannot possibly cater to their hygiene needs as well as feeding them; I think of district nurses who are late home because they would not leave their elderly patient upset after a wound change, and who made them a wee cup of tea and stayed for that comforting chat that time had not been allocated for.”
“In my constituency, we would say “yin, yin, yin.” Seventhly, there must be a long-term, sustainable funding solution for palliative and end-of-life care that can reduce reliance on charitable fundraising and ensure parity of esteem for the NHS and non-NHS palliative care workforce. A transformation fund must also be created to invest in innovative and integrated models of care to meet different community needs. The Minister is probably saying, “My goodness, is it just seven points?”, but yes, I will stop at those seven, although I would like to comment on Sue Ryder if I may.”
“Holding integrated care boards to account for the delivery of this duty must be part of that. Fifthly, we must introduce national quality standards for palliative and end-of-life care that must be met in all health and care settings. That would strengthen accountability while catalysing the 10-year health plan’s targeted shift from hospital to community for patients at the end of life. They must also support more equitable implementation of the vision set out in the ambitious national framework for local action. Sixthly, there must be access to 24/7 support—the very thing being asked for—by creating a universal gateway to 24/7 specialist palliative and end-of-life care advice, guidance and support through NHS 111.”