Cross-Border Terminal Illness & Advance Care Checklist: Australia & United Kingdom

1. 1

   Organizing Palliative and Hospice Care and Cross-Border Healthcare Coverage

   In Australia, a general practitioner or hospital specialist can refer the person to state or territory specialist palliative care teams (for home-based nursing, symptom management, or inpatient hospice units), which can be located through the national directory maintained by Palliative Care Australia [1]. Older people requiring practical domestic assistance, equipment, or respite at home can also be referred for an urgent assessment through My Aged Care (Commonwealth Home Support Programme or Home Care Packages).

   In the United Kingdom, community and inpatient palliative care are coordinated through the National Health Service (NHS) alongside charitable hospices (supported by networks such as Hospice UK and Marie Curie) [6]. Where the person has a rapidly deteriorating condition that may be entering a terminal phase, a clinician can submit a Fast Track Pathway Tool to the local Integrated Care Board for NHS Continuing Healthcare, which arranges fully NHS-funded care at home or in a nursing home without means-testing [6]. Before relocating between Australia and the UK for care, check coverage limits closely: the Australia-UK Reciprocal Health Care Agreement covers medically necessary treatment during temporary visits, but does not fund planned medical relocation or commercial medical repatriation flights.

2. 2

   Executing Valid Written Advance Directives While Full Capacity Remains

   Advance care documents are governed by local statutory frameworks and should be completed in each relevant jurisdiction while the person retains decision-making capacity:

   • Australia: Each state and territory has its own statutory form and witnessing rules for an Advance Care Directive (or Advance Health Directive), available through Advance Care Planning Australia [2]. Once signed and witnessed, the directive should be shared with the treating team and uploaded to the person's My Health Record so emergency and hospital clinicians across Australia can access it [2].
   • United Kingdom: Under the Mental Capacity Act 2005 (in England and Wales), an adult with capacity can make a written, signed, and witnessed Advance Decision to Refuse Treatment (ADRT, often called a Living Will) through the NHS framework; if it refuses life-sustaining treatment, it must explicitly state that it applies even if life is at risk [6]. Clinicians can also record emergency care and resuscitation preferences with the person on a ReSPECT emergency care summary plan.
3. 3

   Establishing Separate Financial and Healthcare Powers of Attorney in Both Jurisdictions

   A power of attorney executed in one country is rarely accepted directly by banks, land registries, or healthcare providers in the other without complex legalisation or court resealing. Separate instruments should be completed while full legal capacity remains:

   • Australia: The person should execute the relevant state or territory Enduring Power of Attorney (covering financial and legal affairs) and Enduring Guardianship or Medical Treatment Decision Maker appointment (guided by Advance Care Planning Australia and the state or territory Public Trustee or Civil and Administrative Tribunal) [2].
   • United Kingdom: In England and Wales, the person can create two separate Lasting Powers of Attorney (one for Health and Welfare and one for Property and Financial Affairs), which must be registered with the Office of the Public Guardian (via GOV.UK and the NHS guidance) before they can be used (or a Continuing and Welfare Power of Attorney registered with the Office of the Public Guardian in Scotland) [7]. Note that all powers of attorney end automatically upon the donor's death [7].
4. 4

   Claiming Fast-Track Terminal Illness Benefits, Disability Support, and Caregiver Leave

   • Australia: Family carers can apply to Services Australia (Centrelink, reachable on 132 300) for the means-tested Carer Payment and the non-means-tested Carer Allowance [3]. Employees in Australia are entitled to paid carer's leave and compassionate leave under the Fair Work National Employment Standards. In addition, a person with a terminal medical condition certified by two medical practitioners (including a relevant specialist) as likely to result in death within 24 months can apply through their superannuation fund and the Australian Taxation Office (ATO) for tax-free early access to superannuation [4].
   • United Kingdom: If a clinician considers that the person's progressive illness is likely to limit life expectancy to 12 months or less, they can complete an SR1 medical form under the Department for Work and Pensions (DWP) Special Rules for End of Life (detailed on GOV.UK) to fast-track claims for Personal Independence Payment (PIP), Attendance Allowance, or Universal Credit at the highest rate without a face-to-face assessment [8]. Qualifying carers providing at least 35 hours of care a week can claim Carer's Allowance, and UK employees have a statutory right to unpaid Carer's Leave [8].
5. 5

   Aligning Wills, Superannuation, Pensions, and Post-Death Estate Administration

   Because both Australia and the UK apply common-law conflict-of-laws rules (where immovable property is governed by the law of the jurisdiction where the land is situated, and movable assets by the law of domicile), families holding assets in both countries often benefit from having separate, carefully coordinated wills in Australia and the UK that explicitly do not revoke one another.

   • Australia: While the person is alive, check whether a valid Binding Death Benefit Nomination is in place with their superannuation fund, as superannuation does not automatically form part of the estate [4]. After a death, notify Services Australia within 28 days (where Carer Payment may continue for up to 14 weeks) [3], use the Australian Death Notification Service (ADNS) for participating banks and utilities, apply for a Grant of Probate through the relevant State or Territory Supreme Court, and have the executor lodge a final Date of Death tax return with the Australian Taxation Office [5].
   • United Kingdom: After a death is registered, use the government's Tell Us Once service on GOV.UK to notify HM Revenue & Customs (HMRC), the Department for Work and Pensions (DWP Bereavement Service / International Pension Centre), the Passport Office, and local councils in one step [9]. Where UK bank accounts or property exceed institutional thresholds, the executor must apply for a Grant of Probate (England and Wales) or Confirmation (Scotland) after submitting the required inheritance tax forms to HMRC.

Official Authorities & Verified Contacts

Official Sources Checked by Clarvia

1. [1]
   Palliative Care Australia - Resources and Service Directory — Palliative Care Australia
2. [2]
   Advance Care Planning Across Australia — Advance Care Planning Australia
3. [3]
   What to do when someone dies - Carer Payment and bereavement support — Services Australia
4. [4]
   Access to super for members with a terminal medical condition — Australian Taxation Office (ATO)
5. [5]
   Doing tax returns for a deceased estate — Australian Taxation Office (ATO)
6. [6]
   Advance decision to refuse treatment (living will) and end of life care — National Health Service (NHS)
7. [7]
   Managing legal affairs for someone with illness - Lasting Power of Attorney — National Health Service (NHS)
8. [8]
   The 'Special Rules': how the benefit system supports people nearing the end of life — Department for Work and Pensions (GOV.UK)
9. [9]
   What to do after someone dies: Tell Us Once — HM Government (GOV.UK)