Families should not need the right postcode to spend a child’s final days at home.
Fifteen of England’s 42 integrated care boards do not commission the round-the-clock home support required for dying children. That can leave families in hospital when they want privacy, familiarity and specialist help at home.
The Health and Care Act already gives boards a legal duty to provide this care. Together for Short Lives has used information requests to identify gaps, while children’s hospices and specialist hospital teams demonstrate how coordinated home care can work.
Publishing one national service standard, named local leads and annual coverage data would turn the duty into something families can rely on. Boards could share staff across boundaries and commission charities as partners where specialist teams are scarce.
Home will not suit every child, and complex care cannot be created by compliance tables alone. Workforce shortages and fragile hospice finances remain. Success means a genuine choice, backed by safe clinical support, not pressure to leave hospital.