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Country/JA: Germany flag Germany
Action type: Legal framework

Problem: Although not cancer specific the Hospice and Palliative Care Act is key to the provision of end of life care to cancer patients.

Objective: Equitable access to hospice and palliative care services for all settings (at home, nursing/care homes, hospitals and hospices).

Implementation status: Fully implemented and ongoing

Key Contextual Factors

  • The German statutory health insurance covers completely the necessary medical care for terminally ill patients.

Key Components/Steps

  • November 2015: The Hospice Palliative Care Act was passed by the German Parliament and came into force in December 2015.
  • The main objectives of the act were:
  • Improving access to hospice and palliative care services for all settings in Germany.
  • Strengthening cooperation between professional and voluntary services, medical, nursing, hospice and psychosocial support in networks.
  • Provision of customized advice and support to patients/families about the availability of services.
  • Implementation at the federal level and Laender/regional level by way of secondary legislation (guidelines, regulations, contractual agreement, legal acts).

Main Impacts / Added Value

The “2015 Hospice Palliative Care Act” has significantly:

  • Further developed hospice and palliative care in Germany ensuring equitable access to multi-disciplinary and cross-sectoral services for all settings (at home, nursing/care homes, hospitals and hospices).
  • Provided legal clarification that palliative care is an integral part of medical care provided by the German Statutory Health Insurance.
  • Introduced additional ambulatory medical services for the delivery of especially qualified and coordinated medical care.
  • Improved funding of hospices for children and adults (in-patient care) as well as ambulatory hospice care.
  • Strengthened palliative care and the awareness for the need of hospice care in in-patient nursing homes as well as hospitals.

Lessons Learned

  • In a federal system formal approaches (e.g. legislation) are effective to implement programmatic public health policy. Involvement of all stakeholders and levels of decision making is paramount.

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References and Documentation

  • 2015 Hospice Palliative Care Act
  • The Hospice and Palliative Care Act builds on pre-existing regulations in the area of hospice and palliative care. All of the relevant organisations and players in the field of hospice and palliative care had been involved in the decision making process.


  • Institution/organization: Federal Ministry of Health, Germany
  • Department/lead: Division 221 “Key Policy Issues Concerning the Statutory Health Insurance System”
  • E-mail: