End of Life Doula UK welcomes the renewed commitment to shifting care from hospitals into communities, as outlined in the 10 Year Health Plan for England. It’s encouraging to see a move towards care that is more relational, local, and responsive to people’s lives outside clinical settings.
However, we urge policymakers to look beyond expanding formal services. The health of our communities relies not only on professional input, which is a vital but small part of what people need at the end of life, but on our capacity to care for one another. End of life doulas are independent of statutory services and systems, embedded within their communities, and grounded in relationships. They offer non-medical, practical, emotional, and spiritual support to people at the end of life and those close to them – support that sits outside conventional models of provision but is vital to what matters most.
We believe the plan must include a focus on mobilising and resourcing community-led care, not just scaling up formal provision. Supporting informal networks, building death literacy and competency, and recognising the value of non-clinical roles like end of life doulas are all essential if we want to see lasting change.
It’s also good to see recognition in the plan of the role unpaid carers play, and the intention to provide better tools to support their involvement in care planning. Too often, these carers – family, friends, neighbours – hold the system together without enough support themselves. Any effort to make their role more visible and more supported is welcome.
We also note the plan’s emphasis on digital transformation. While there are clear benefits to improving access and coordination through technology, we urge caution. Digital solutions must not deepen existing health inequalities.Not everyone can, or will, access services online or via apps. Some of the most vulnerable people, especially at the end of life, are at risk of being left behind if in-person, relational, and accessible care is not protected and prioritised.
We look forward to contributing to this national conversation, and to helping shape a future where end of life care is more than service provision, but rooted in community, and built around what people truly need as they approach death.
