{"id":7981,"date":"2026-10-12T21:59:07","date_gmt":"2026-10-12T21:59:07","guid":{"rendered":"https:\/\/www.visiting-angels.co.uk\/cheshire-east\/?p=7981"},"modified":"2026-10-12T22:12:52","modified_gmt":"2026-10-12T22:12:52","slug":"end-of-life-care-at-home","status":"publish","type":"post","link":"https:\/\/www.visiting-angels.co.uk\/cheshire-east\/end-of-life-care-at-home\/","title":{"rendered":"End of life care at home: what it involves and who pays"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"7981\" class=\"elementor elementor-7981\" data-elementor-post-type=\"post\">\n\t\t\t\t<div class=\"elementor-element elementor-element-2607b910 e-flex e-con-boxed e-con e-parent\" data-id=\"2607b910\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-d2e8bff elementor-widget elementor-widget-text-editor\" data-id=\"d2e8bff\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<h3><b>Quick summary<\/b><\/h3><p><span style=\"font-weight: 400;\">Most people say they would prefer to die at home, and far fewer do. Money and speed are usually the reasons, and both can be sorted faster than families realise. Fast Track NHS Continuing Healthcare funds the whole package, is not means-tested, and the national framework expects care to be in place within 48 hours.<\/span><\/p><p>\u00a0<\/p><h3><b>The gap between wishes and what happens<\/b><\/h3><p><span style=\"font-weight: 400;\">Marie Curie&#8217;s research has consistently found that a substantial majority of people would choose to die at home, while a much smaller proportion actually do, with hospital remaining the most common place of death. Home deaths rose after 2020 and the gap has not closed.<\/span><\/p><p><span style=\"font-weight: 400;\">It is rarely because families do not want it. It is because nobody explained the funding, or because the care could not be arranged quickly enough, and an admission happened instead.<\/span><\/p><p>\u00a0<\/p><h3><b>Fast Track funding<\/b><\/h3><p><span style=\"font-weight: 400;\">Where someone has a rapidly deteriorating condition and may be entering a terminal phase, a clinician can complete a <\/span><b>Fast Track Pathway Tool<\/b><span style=\"font-weight: 400;\"> for NHS Continuing Healthcare.<\/span><\/p><ul><li style=\"font-weight: 400;\" aria-level=\"1\"><b>It funds 100 per cent of the care package<\/b><span style=\"font-weight: 400;\">, at home, in a hospice or in a care home.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>It is not means-tested.<\/b><span style=\"font-weight: 400;\"> Savings, income and the house are irrelevant.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>The national framework expects care to be commissioned within 48 hours<\/b><span style=\"font-weight: 400;\"> of the completed tool reaching the Integrated Care Board.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>It can be completed by an appropriate clinician<\/b><span style=\"font-weight: 400;\">, including a GP, hospital consultant, specialist nurse or hospice doctor.<\/span><\/li><\/ul><p><b>Ask for it by name.<\/b><span style=\"font-weight: 400;\"> Marie Curie&#8217;s own research into delivery found significant variation in how quickly Fast Track packages were actually delivered, and some people unfortunately died waiting. Families who know the words get a faster answer than families who ask generally about funding.<\/span><\/p><p><span style=\"font-weight: 400;\">Our <\/span><a href=\"https:\/\/www.visiting-angels.co.uk\/cheshire-east\/nhs-continuing-healthcare\/\"><span style=\"font-weight: 400;\">guide to Continuing Healthcare<\/span><\/a><span style=\"font-weight: 400;\"> covers the standard route, which is slower and works differently.<\/span><\/p><p>\u00a0<\/p><h3><b>Who does what<\/b><\/h3><p><span style=\"font-weight: 400;\">End of life care at home is not one service. It is several, and knowing who does what saves a lot of ringing round.<\/span><\/p><table><thead><tr><th><p><b>Who<\/b><\/p><\/th><th><p><b>What they do<\/b><\/p><\/th><\/tr><\/thead><tbody><tr><td><p><b>GP<\/b><\/p><\/td><td><p><span style=\"font-weight: 400;\">Oversees medical care, prescribes, visits, and can complete the Fast Track tool<\/span><\/p><\/td><\/tr><tr><td><p><b>District nurses<\/b><\/p><\/td><td><p><span style=\"font-weight: 400;\">Nursing care: injections, syringe drivers, wounds, catheters, pressure care. They usually coordinate the clinical side<\/span><\/p><\/td><\/tr><tr><td><p><b>Specialist palliative care and hospice teams<\/b><\/p><\/td><td><p><span style=\"font-weight: 400;\">Symptom control advice, and support for the family. East Cheshire Hospice serves much of this area<\/span><\/p><\/td><\/tr><tr><td><p><b>Hospice at home and Marie Curie nurses<\/b><\/p><\/td><td><p><span style=\"font-weight: 400;\">Overnight and hands-on nursing support where available. Free at the point of use, and capacity is limited<\/span><\/p><\/td><\/tr><tr><td><p><b>Home care providers<\/b><\/p><\/td><td><p><span style=\"font-weight: 400;\">Personal care, meals, company, sitting, and supporting the family day to day<\/span><\/p><\/td><\/tr><tr><td><p><b>Out of hours and 111<\/b><\/p><\/td><td><p><span style=\"font-weight: 400;\">Overnight and weekend advice, which is when most crises happen<\/span><\/p><\/td><\/tr><\/tbody><\/table><p>\u00a0<\/p><p><span style=\"font-weight: 400;\">A home care provider does not give injections or manage syringe drivers. Those are nursing tasks, and the care plan should be clear about the boundary.<\/span><\/p><p>\u00a0<\/p><h3><b>What to put in place early<\/b><\/h3><p><span style=\"font-weight: 400;\">The families who manage best at home have usually sorted these before they were urgently needed.<\/span><\/p><ul><li style=\"font-weight: 400;\" aria-level=\"1\"><b>The Fast Track application.<\/b><span style=\"font-weight: 400;\"> First, because it unlocks everything else.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Anticipatory medicines in the house<\/b><span style=\"font-weight: 400;\">, sometimes called just in case medicines, prescribed by the GP so that district nurses can act quickly at night.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>An out of hours plan<\/b><span style=\"font-weight: 400;\">, including who to ring at 3am and a record that the person wishes to be at home.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Equipment.<\/b><span style=\"font-weight: 400;\"> A profiling bed, pressure-relieving mattress, commode. District nurses or occupational therapy arrange these, usually quickly at this stage.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>A discussion about resuscitation and preferences<\/b><span style=\"font-weight: 400;\">, recorded where out of hours services can see it.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Night cover.<\/b><span style=\"font-weight: 400;\"> The most common reason a home plan fails is exhaustion, not medicine.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>A key safe<\/b><span style=\"font-weight: 400;\">, so nobody is left outside at night.<\/span><\/li><\/ul><p>\u00a0<\/p><h3><b>What home care actually provides<\/b><\/h3><ul><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Personal care<\/b><span style=\"font-weight: 400;\">, washing, changing, mouth care and keeping someone comfortable and dignified.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Help with eating and drinking<\/b><span style=\"font-weight: 400;\">, for as long as that is wanted, and accepting when it is not.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Sitting services<\/b><span style=\"font-weight: 400;\">, so somebody is there and the family can sleep.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Overnight and live-in support.<\/b><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Company for the person<\/b><span style=\"font-weight: 400;\">, and someone to notice changes and call the district nurse.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Practical support for the household<\/b><span style=\"font-weight: 400;\">, which nobody else picks up.<\/span><\/li><\/ul><p><span style=\"font-weight: 400;\">The part families value most is usually the least clinical: not being alone with it at two in the morning.<\/span><\/p><p>\u00a0<\/p><h3><b>Being honest about home<\/b><\/h3><p><span style=\"font-weight: 400;\">Home is right for many people and it is not right for everyone.<\/span><\/p><p><span style=\"font-weight: 400;\">A hospice bed may give better symptom control where pain or breathlessness is difficult. Some people find home frightening once they are very unwell. Some houses cannot accommodate a bed downstairs, and some families cannot sustain it, which is not a failure.<\/span><\/p><p>\u00a0<\/p><h3><b>Support for the family<\/b><\/h3><p>\u00a0<\/p><ul><li style=\"font-weight: 400;\" aria-level=\"1\"><b>A carer&#8217;s assessment<\/b><span style=\"font-weight: 400;\"> from the council, in your own right.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Hospice family support and bereavement services<\/b><span style=\"font-weight: 400;\">, which often begin before the death and continue afterwards.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Marie Curie&#8217;s support line<\/b><span style=\"font-weight: 400;\"> and information services.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Your own GP.<\/b><span style=\"font-weight: 400;\"> Ask to be recorded as a carer.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Practical help<\/b><span style=\"font-weight: 400;\">, which our <\/span><a href=\"https:\/\/www.visiting-angels.co.uk\/cheshire-east\/parent-refuses-care\/\"><span style=\"font-weight: 400;\">guidance for families<\/span><\/a><span style=\"font-weight: 400;\"> and the carers&#8217; support piece cover in more detail.<\/span><\/li><\/ul><p>\u00a0<\/p><h3><b>Frequently asked questions<\/b><\/h3><p><b>Who pays for end of life care at home?<\/b><\/p><p><span style=\"font-weight: 400;\">Where Fast Track Continuing Healthcare applies, the NHS funds the whole package and it is not means-tested. Outside that, care is arranged through the council after a financial assessment, or privately.<\/span><\/p><p><b>How quickly can it be arranged?<\/b><\/p><p><span style=\"font-weight: 400;\">The national framework expects a Fast Track package within 48 hours of the application reaching the Integrated Care Board. Delivery varies, so ask for progress daily and escalate if nothing moves.<\/span><\/p><p><b>Who completes the Fast Track form?<\/b><\/p><p><span style=\"font-weight: 400;\">An appropriate clinician: GP, consultant, specialist nurse or hospice doctor. Ask directly whether a Fast Track application is appropriate.<\/span><\/p><p><b>What if we are turned down?<\/b><\/p><p><span style=\"font-weight: 400;\">Ask for the reasons, and ask the GP or specialist nurse to review whether the criteria are met. A care needs assessment from the council should run alongside in any case.<\/span><\/p><p><b>Does Fast Track funding stop if they live longer than expected?<\/b><\/p><p><span style=\"font-weight: 400;\">Fast Track awards are reviewed, and some people remain on them for a considerable time. A review is not the same as withdrawal.<\/span><\/p><p><b>Can carers give pain relief?<\/b><\/p><p><span style=\"font-weight: 400;\">Home care workers can support medicines in line with the care plan and their training. Injectable medicines and syringe drivers are nursing tasks handled by district nurses.<\/span><\/p><p>\u00a0<\/p><h3><b>About Visiting Angels Cheshire East<\/b><\/h3><p><span style=\"font-weight: 400;\">Visiting Angels Cheshire East provides care at home across Macclesfield, Wilmslow, Knutsford, Congleton, Alsager and the surrounding villages of East Cheshire, along with Buxton, Whaley Bridge and the Staffordshire Moorlands towns.<\/span><\/p><ul><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Overnight, sitting and live-in support<\/b><span style=\"font-weight: 400;\">, so families are not awake every night.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>No visit is ever shorter than an hour.<\/b><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>You see the same faces<\/b><span style=\"font-weight: 400;\">, which matters a great deal at this stage. Our carer turnover is 12 per cent, against a sector figure of 23.7 per cent (<\/span><a href=\"https:\/\/www.skillsforcare.org.uk\/\"><span style=\"font-weight: 400;\">Skills for Care, 2025<\/span><\/a><span style=\"font-weight: 400;\">).<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>We work alongside district nurses and the hospice<\/b><span style=\"font-weight: 400;\">, not instead of them.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Care can often start within a few days<\/b><span style=\"font-weight: 400;\">, and faster where Fast Track funding is in place.<\/span><\/li><\/ul><p><span style=\"font-weight: 400;\">David&#8217;s mother in law is supported at home:<\/span><\/p><p><i><span style=\"font-weight: 400;\">&#8220;Visiting angels have been a massive help in the care for my mother in law, who is getting increasingly confused. They provide companionship and support every day proving to be very reliable and consistent. They are there at times we can&#8217;t be, due to all the commitments of work and grand children.&#8221;<\/span><\/i><\/p><p><span style=\"font-weight: 400;\">David Figg, Google review<\/span><\/p><p>\u00a0<\/p><h3><b>Talking it through<\/b><\/h3><p><span style=\"font-weight: 400;\">There is no assessment fee and no obligation. If someone wants to be at home and you are trying to work out whether it is possible, we can talk through what would be needed, what the NHS should be funding, and what we would cover.<\/span><\/p><p><span style=\"font-weight: 400;\">Call us on 01625 720157. You can also <\/span><a href=\"https:\/\/www.visiting-angels.co.uk\/cheshire-east\/enquire-now\/\"><span style=\"font-weight: 400;\">send an enquiry<\/span><\/a><span style=\"font-weight: 400;\">, and you can see <\/span><a href=\"https:\/\/www.visiting-angels.co.uk\/cheshire-east\/services\/home-care-services\/\"><span style=\"font-weight: 400;\">what our services cover<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p><p><span style=\"font-weight: 400;\">Authored by Dr Haroon Ahmad, Managing Director, Visiting Angels Cheshire East.<\/span><\/p><p><span style=\"font-weight: 400;\">Published 27 September 2026. Last updated 27 September 2026.<\/span><\/p><p><i><span style=\"font-weight: 400;\">This article is general information about end of life care and funding, not medical, financial or legal advice. Decisions about treatment, symptom control and eligibility rest with the clinical team and the Integrated Care Board. The author is a director of the company and is not acting in a clinical capacity, and Visiting Angels Cheshire East provides personal care at home rather than medical or nursing care. National framework guidance and local services change; check the current position. Support is available from Marie Curie, your local hospice and Cruse Bereavement Support. To the fullest extent permitted by law, GB Care at Home Ltd accepts no liability for any loss arising from reliance on this article.<\/span><\/i><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Quick summary Most people say they would prefer to die at home, and far fewer do. Money and speed are [&hellip;]<\/p>\n","protected":false},"author":81,"featured_media":7944,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"default","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[35,36],"tags":[],"class_list":["post-7981","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-funding","category-blog"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>End of life care at home: what it involves and who pays | Cheshire East<\/title>\n<meta name=\"description\" content=\"Fast Track NHS Continuing Healthcare funds the whole package, is not means-tested, and should be in place within 48 hours. 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