Almost one in three people in England die without the basic end-of-life care they need
16 February 2026
New Hull York Medical School research finds that around 170,000 people in England each year spend their final days in pain, distress, or without essential end-of-life support.
The study – the first major analysis in more than a decade to estimate unmet palliative care needs – found that almost one in three people who die do so with unaddressed symptoms, psychosocial concerns, or with little or no GP support, despite evidence that appropriate care could have helped.
Researchers from the Wolfson Palliative Care Research Centre at Hull York Medical School, the University of Hull, and King’s College London, with support from the University of Edinburgh and funding from Marie Curie, warn that unmet need will continue to rise without urgent action.
Unmet palliative care need is projected to increase by 21% over the next 25 years, meaning that by 2050 more than 212,000 people a year in the England could die without the care they require.
Professor Fliss Murtagh, Director of the Wolfson Palliative Care Research Centre, said:
“These findings are a stark warning that our systems are not meeting the needs of a growing older population at the end of their lives. The evidence shows not just gaps in care, but systemwide limitations that repeatedly fail people during their final months.”
Dr Anna Bone, lead author and Lecturer in Epidemiology and Palliative Care at King’s College London, said:
“Many people are reaching the end of their lives with distressing symptoms that aren’t being addressed, and without feeling adequately supported by primary care. The number of people experiencing unmet needs is likely to rise further. At such a profoundly difficult time, everyone should be able to access the care and support they need.”
The UK Government had committed to publishing a Palliative and End of Life Care Modern Service Framework this spring; publication has now been delayed until autumn.
Samina, from West Yorkshire, described being left without support when her aunt with late-stage cancer left hospital after three and a half months. “My aunt didn’t speak English and didn’t understand what was happening. It was left to us to try and explain but it was difficult for us to ask questions as everyone was so busy and we didn’t want to cause a nuisance.
“She didn’t want to die in hospital, as her husband had. She wanted to be at home with her family. But assessments and referrals after her discharge were lost in the system. We were told people would visit, and no one came. After many calls to the GP, a community nurse finally visited in her last weeks. We even had to chase her death certificate so we could bury her. We were left on our own, and I felt responsible for everything.”
Matthew Reed, Chief Executive of Marie Curie, said:
“The evidence is clear. People are reaching the end of their lives without basic palliative care, causing pain and distress that is often avoidable – and the situation is getting worse. The Modern Service Framework is a critical opportunity to fix this, but only if it delivers guaranteed 24/7 palliative care in every community, backed by proper funding. The UK Government has the evidence it needs, it must act. Dying people cannot afford further delay.”
About the study
The research sought to determine how many people are missing out on necessary palliative care. A commonly cited statistic, that one in four people do not get the end-of-life care they need, is based on broad assumptions. This study aimed to provide a clearer, agreed definition and more accurate assessment to inform policy and practice.
Through workshops with people affected by terminal illness and with health and care professionals, researchers developed the following definition:
‘Unmet palliative care needs are present when a person with life-limiting illness has symptoms, psychosocial concerns, or care requirements that are not adequately addressed through available services, with inability to access or receive person-centred care.’
Using this definition, the team analysed data from a nationally representative ONS survey of 1,194 bereaved family carers across England and Wales (May–November 2023). Someone was considered to have unmet palliative care needs if they had both unaddressed symptoms and concerns and insufficient access to GP support.
Bone, A.E., Diggle, M., Johansson, T. et al. Coproducing a conceptual understanding of unmet palliative care needs: stakeholder workshops using modified nominal group technique. BMC Palliat Care 25, 30 (2026)
The study was conducted by
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