Background Increasing availability of, and access to, palliative and end of life care services (PEoLC) could be a means of reducing systemic pressures on hospital and ambulance services, as well as improving end of life care for patients and families (Imison, Curry, Holder, et al. Shifting the balance of care: great expectations.: Nuffield Trust; 2017). In the context of severe financial constraints, commissioning these services requires economic evidence to compete for scarce resources (May, Morrison, Murtagh. Palliat Med. 2017;31(4):293–5). Geographically-specific evidence is of importance to be able to generalise results from research studies to commissioning and practice (Fischer, Bednarz, Simon. Palliat Med. 2024;38(1):85–99).

Aim To synthesise evidence from economic evaluations of UK-based PEoLC services published 2014–2024 on the benefits for patients and families, changes in service use and costs, and overall cost effectiveness.

Method Searches were made of nine academic databases and grey literature. Search results were screened along with reference lists and citations of thirty-six geographically non-specific review papers. Study characteristics and results were extracted to a table and are being analysed and synthesised.

Results Twelve original studies met the criteria, including 5 randomised controlled trials, a decision-analytic model, observational studies and service evaluations across a range of hospital and community settings. Three grey literature reports were found. Most studies were small scale and many included limitations such as short follow up periods and poor or no comparison groups. Interim analysis indicates mixed results, with some evidence of benefits for patients, particularly where palliative care-specific measures were used and reductions in acute service use with consequent cost avoidance.

Conclusion The economic evaluation evidence base for UK PEoLC services is limited. However, there is some evidence of reductions in acute service use and consequent cost avoidance as well as benefits to patients and carers. There is a need for more well-designed large scale economic evaluations in UK settings to strengthen the evidence base for PEoLC services.