Palliative care in the UK is funded through a mixture of NHS provision, local authority support, charitable funding and in some circumstances private payment. For most people, the core of their palliative care is provided free at the point of need through the NHS. Understanding what is covered and what is not, and how different funding routes work together, helps families plan ahead with confidence rather than face unexpected costs at the most difficult time.
NHS-Funded Palliative Care
The NHS has a duty to provide palliative care to people with life-limiting illness, and much of what falls under palliative care is funded entirely by the NHS. This includes:
- GP and district nursing support in the community
- Specialist palliative care nurse input, including Macmillan nurses and clinical nurse specialists
- Hospital palliative care teams
- Medications prescribed for symptom control
- Hospice care, which is predominantly NHS and charity funded
- Psychological support provided through NHS services
The principle that underlies NHS palliative care funding is that healthcare needs, including the management of pain and symptoms in a life-limiting illness, should be met by the NHS regardless of a person’s financial circumstances. This is different from social care needs, which are means tested.
NHS Continuing Healthcare and Palliative Care
For people with complex, ongoing health needs arising from a life-limiting illness, NHS Continuing Healthcare (CHC) may cover the full cost of their care package, including accommodation in a care home. CHC is not means tested. If a person meets the eligibility threshold, the NHS covers the entire cost regardless of their savings or assets.
CHC eligibility is based on whether a person has a primary health need, meaning their care needs are primarily driven by health rather than social care requirements. People with advanced cancer, end-stage neurological conditions or very complex symptom management needs are among those who may qualify.
For people who are approaching the end of life and whose condition is deteriorating rapidly, the CHC Fast Track Pathway provides a quicker route to funded care. A clinician can complete a Fast Track assessment and, if accepted, a care package can be in place within 48 hours with the NHS covering the full cost.
NHS-Funded Nursing Care
For people living in nursing care homes who do not meet the full CHC threshold, NHS-funded Nursing Care (FNC) provides a flat-rate NHS contribution toward the cost of registered nursing care. This is paid directly to the care home and reduces the amount the individual or local authority needs to contribute. It is not means tested and applies to anyone in a nursing home who has been assessed as needing nursing care.
What the Local Authority Funds
Local authorities fund social care needs rather than health needs. For people with palliative care needs who do not qualify for CHC, the local authority may contribute to the cost of care based on a care needs assessment and a means test.
The means test looks at a person’s capital, including savings and property, against set thresholds. In England, those with capital above £23,250 are expected to fund their own care. Those between £14,250 and £23,250 receive partial support, and those below £14,250 have their care funded in full by the local authority, subject to a contribution from income.
Local authority funding covers care home fees or home care packages for those who qualify. It does not cover healthcare costs, which remain the responsibility of the NHS.
Hospice Funding
Hospices in the UK occupy a unique funding position. Most are independent charities that receive a proportion of their funding from the NHS through local commissioning arrangements and raise the rest through charitable fundraising. This means that inpatient hospice care, day hospice services and hospice at home services are generally available free of charge to people who need them, regardless of their financial circumstances.
The proportion of NHS funding that hospices receive varies significantly across the country. Some hospices receive around a third of their costs from the NHS; others receive more or less. The charitable element is why hospice fundraising matters so much to the communities they serve.
Palliative Care in a Care Home: Who Pays?
For people receiving palliative care in a care home, the funding picture combines several different sources depending on the individual’s circumstances.
| Funding Source | What It Covers | Means Tested? |
|---|---|---|
| NHS Continuing Healthcare | Full cost of care including accommodation, for those with a primary health need | No |
| NHS-funded Nursing Care | Flat-rate contribution toward nursing care costs in a nursing home | No |
| NHS (community services) | District nursing, specialist palliative nurses, medications, GP visits | No |
| Local authority | Contribution to care home fees for those below the capital threshold | Yes |
| Individual/self-funder | Care home fees for those above the capital threshold, or where CHC does not apply | N/A |
| Hospice (charitable) | Specialist input, advice and support from hospice teams in the community or as an inpatient | No |
At our homes across Worcestershire, Berkshire, Middlesex, Leicester, Birmingham and Milton Keynes, our admissions teams regularly help families understand which funding routes apply to their situation. We work with NHS community nurses, palliative care specialists and hospice teams to ensure that the clinical aspects of palliative care are provided through NHS channels wherever possible.
“The funding landscape for palliative care can feel complicated at a time when families already have enough to deal with. At Blissful Care Homes, we try to make it as clear as possible what is covered by the NHS, what may be fundable through other routes, and how we can help families navigate the process.”
Blissful Care Homes
Prescription Charges and Palliative Care
People with a life-limiting illness are entitled to free NHS prescriptions in England. This is available through a Medical Exemption Certificate, which can be applied for through a GP. It covers all prescription medications, not just those directly related to the palliative condition.
Financial Support and Benefits
People living with a serious or terminal illness and their carers may be entitled to a range of benefits that can help with the additional costs of illness. These include:
- Attendance Allowance for those over State Pension age who need help with personal care or supervision
- Personal Independence Payment (PIP) for those under State Pension age
- Carer’s Allowance for those providing more than 35 hours of care per week
- Pension Credit, which can top up income for those on a low pension
- Council Tax Reduction, which may apply where income is limited
For people with a terminal diagnosis, the Special Rules for Terminal Illness (SRTI) allow fast-tracked access to certain benefits without the usual waiting periods or assessments. This applies to people whose illness may reasonably be expected to cause death within 12 months.
Planning Ahead
The most important financial step a family can take when a loved one has a life-limiting illness is to understand the funding picture early, before a crisis makes the decisions urgent. This means requesting a CHC assessment as soon as needs become complex, ensuring all eligible benefits are claimed, understanding what the care home fee covers and what additional costs may arise, and taking independent financial advice where significant assets are involved.
Our article on when to introduce palliative care explains why earlier planning, both clinically and financially, leads to better outcomes for everyone involved.
“No family should feel that financial uncertainty is preventing their loved one from receiving the care they need. Understanding what is available and asking for it early is one of the most important things a family can do. We are always happy to help families work through the questions.”
Blissful Care Homes
Frequently Asked Questions
Is palliative care free in the UK?
The healthcare elements of palliative care, including nursing, specialist support, medications and hospice services, are generally available free through the NHS and charitable hospices. The social care elements, such as residential care home fees, may involve means-tested contributions from the individual unless NHS Continuing Healthcare applies.
Does having savings affect entitlement to palliative care?
NHS healthcare services are not means tested, so savings do not affect access to NHS palliative care. Local authority funding for care home fees or social care support is means tested and will be affected by capital above the relevant thresholds.
Can a terminally ill person get fast-tracked for NHS funding?
Yes. The CHC Fast Track Pathway allows a clinician to recommend immediate NHS funding for someone who is rapidly deteriorating or approaching end of life. If accepted, a care package can be arranged within 48 hours with the NHS meeting the full cost.
What happens if NHS Continuing Healthcare is refused?
A refusal can be challenged through a local review and, if necessary, an independent review by NHS England. Many CHC applications succeed on appeal. Independent advice is available through the Beacon CHC advisory service on 0345 548 0300. Our article on understanding the stages of palliative care also covers how care needs are assessed at different points in the journey.
Are hospice services really free?
Yes. Hospice care, whether inpatient, day services or hospice at home, is provided free of charge to those who need it. Hospices are funded through a combination of NHS commissioning and charitable fundraising.
What benefits can a terminally ill person claim?
Attendance Allowance or PIP, Carer’s Allowance for those looking after them, and potentially Pension Credit and Council Tax Reduction may all apply. The Special Rules for Terminal Illness provide fast-tracked access to certain benefits for those with a prognosis of 12 months or less. A benefits adviser or Macmillan social worker can help identify everything that is claimable.
Talk to Our Team
If you are supporting a relative with a serious or terminal illness and want to understand how palliative care is funded at our homes across Bricklehampton Hall, Broadmead, Coppermill Care, Hayes Park, New Day and The Lindens, our admissions teams are happy to help guide you through the options.
You may also find our article on the care we provide helpful as you think through next steps.
