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

1. 1

   Palliative and Hospice Care and Cross-Border Healthcare Coordination

   In the United Kingdom, the primary route for symptom control and community support is through the person's GP or hospital specialist, who can refer the person to local National Health Service (NHS) specialist palliative care teams and charitable hospices supported by networks such as Hospice UK and Marie Curie [1]. If your family member has rapidly deteriorating needs and may be entering a terminal phase, ask an appropriate clinician (such as a hospital consultant, GP, or community nurse) to submit the NHS Continuing Healthcare Fast Track Pathway Tool so an urgent, fully NHS-funded care package at home, in a care home, or in a hospice can be arranged without means testing [1].

   In Australia, specialist palliative care is coordinated through state and territory public health networks, general practitioners, and community palliative teams, which can be located through the national directory maintained by Palliative Care Australia [2]. For older adults requiring home-based practical support alongside palliative treatment, referrals can also be arranged through My Aged Care and the Commonwealth Home Support Programme [2][3]. If the family is considering relocating between the UK and Australia for care, confirm coverage and fitness-to-fly rules before booking travel: the UK-Australia Reciprocal Health Care Agreement covers only medically necessary treatment for temporary visitors and does not fund planned cross-border palliative relocation, non-emergency medical repatriation, or long-term residential care.

2. 2

   Written Advance Directives and Emergency Care Plans in Both Countries

   While your family member has full mental capacity, separate written advance care documents should be completed for each country where care may take place, as clinical forms are not automatically recognized across borders.

   • United Kingdom: In England and Wales, the person can make a written Advance Decision to Refuse Treatment (ADRT, often called a Living Will) under the Mental Capacity Act 2005 [1]. To refuse life-sustaining treatment (such as cardiopulmonary resuscitation, mechanical ventilation, or artificial nutrition and hydration), the ADRT must be in writing, signed and witnessed, and contain an explicit statement that the refusal applies even if life is at risk [1]. Alongside an ADRT, ask the clinical team to complete a ReSPECT emergency care and treatment summary plan and an Advance Statement of general care preferences so ambulance crews and out-of-hours doctors have immediate clinical guidance [1].
   • Australia: Advance Care Directives are governed by state and territory legislation (for example, in New South Wales, Victoria, Queensland, or Western Australia), with official state-specific forms and guidance provided through Advance Care Planning Australia (national advisory line 1300 208 582) [3]. Once completed, signed, and witnessed according to the relevant state or territory rules, upload a copy of the Advance Care Directive directly to the person's My Health Record via myGov and share copies with the treating GP and hospital team [3].
3. 3

   Separate Financial and Healthcare Powers of Attorney

   A power of attorney registered in the UK is generally not accepted directly by Australian banks, land registries, or hospitals, and vice versa. Separate instruments should be executed in both jurisdictions while your family member retains full legal capacity.

   • United Kingdom: In England and Wales, the person should make and register two separate Lasting Powers of Attorney (LPAs) with the Office of the Public Guardian (phone 0300 456 0300): one LPA for Health and Welfare (which takes effect only when mental capacity is lost) and one LPA for Property and Financial Affairs (which can be used as soon as registered, with the person's consent) [4]. If the person lives or holds property in Scotland, prepare a Continuing and Welfare Power of Attorney registered with the Office of the Public Guardian (Scotland), or an Enduring Power of Attorney in Northern Ireland [4].
   • Australia: The person should execute a state or territory Enduring Power of Attorney covering financial and legal affairs (for banks, real estate, and superannuation communication) as well as a separate medical authority (called an Enduring Guardian in New South Wales and Tasmania, a Medical Treatment Decision Maker in Victoria, or included within an Advance Health Directive in Queensland and Western Australia) following the statutory witnessing rules of that state or territory [3].
4. 4

   Fast-Track Terminal Illness Benefits, Superannuation, and Caregiver Leave

   Both countries offer expedited financial pathways and workplace protections when a terminal diagnosis is confirmed.

   • United Kingdom: Under the Department for Work and Pensions (DWP) Special Rules for End of Life, if a clinician expects death within 12 months, ask the doctor or specialist nurse to complete an SR1 medical form [5]. This fast-tracks claims for Personal Independence Payment (PIP), Attendance Allowance, or Universal Credit without a face-to-face assessment and at enhanced rates [5]. Family caregivers providing at least 35 hours of care per week can claim Carer's Allowance, and employees in Great Britain have a statutory right to up to one week of unpaid Carer's Leave per year to provide or arrange care for a dependant with a long-term care need [6].
   • Australia: Family carers residing in Australia can apply to Services Australia (Centrelink carer line 132 717) for the means-tested Carer Payment and the supplementary Carer Allowance [7]. Under the Fair Work system, employees are entitled to paid personal/carer's leave and compassionate leave when an immediate family or household member has a life-threatening illness. In addition, under rules administered by the Australian Taxation Office (ATO), if two registered medical practitioners (including at least one specialist in the relevant field) certify that the illness is likely to result in death within 24 months, your family member can apply to their superannuation fund (or via the ATO for ATO-held super) for early, tax-free lump-sum release of superannuation under the terminal medical condition condition of release [8].
5. 5

   Aligning Wills, Superannuation Nominations, and Post-Death Administration

   Reviewing estate and notification arrangements in advance avoids conflicting probate filings and tax traps across the two jurisdictions.

   • Wills and Superannuation Alignment: Ask a cross-border solicitor or estate lawyer to ensure that separate UK and Australian wills cover assets in each respective jurisdiction without inadvertently revoking one another through a global revocation clause. In Australia, superannuation does not automatically form part of the estate under a will; check that a valid Binding Death Benefit Nomination is on file with the super fund and note that withdrawing super tax-free during the person's lifetime under a terminal medical condition can differ significantly in tax treatment from a post-death superannuation death benefit paid to non-tax-dependant adult beneficiaries [8].
   • United Kingdom Post-Death Steps: After a death in the UK, once the death is registered, use the Tell Us Once service to notify HM Revenue & Customs (HMRC), the Department for Work and Pensions (including the DWP Bereavement Service and International Pension Centre), passport offices, and local councils in a single step [9]. An executor or administrator applies for a Grant of Probate (or Letters of Administration) in England and Wales (or Confirmation in Scotland) to administer UK bank accounts and property [10].
   • Australia Post-Death Steps: Notify Services Australia (Centrelink and Medicare on 132 300) within 28 days of a death; eligible carers receiving Carer Payment may continue receiving support for up to 14 weeks after the death [7]. Families can use the Australian Death Notification Service (ADNS) to notify multiple banks, utilities, and super funds online, while the executor or legal personal representative applies to the relevant State or Territory Supreme Court for a Grant of Probate (or resealing of a UK grant) and submits a final Date of Death tax return and any deceased estate trust return to the Australian Taxation Office (ATO) [8].

Official Authorities & Verified Contacts

Official Sources Checked by Clarvia

1. [1]
   Advance decision to refuse treatment (living will) and end of life care — National Health Service (NHS)
2. [2]
   Palliative Care and Advance Care Planning Resources — Palliative Care Australia
3. [3]
   Advance Care Planning Explained across Australian States and Territories — Advance Care Planning Australia
4. [4]
   Make, register or end a lasting power of attorney — GOV.UK / Office of the Public Guardian
5. [5]
   Get benefits faster if you are nearing the end of life (Special Rules) — GOV.UK / Department for Work and Pensions
6. [6]
   Carer's Allowance and support for carers — GOV.UK
7. [7]
   What to do when a loved one dies and Carer Payment adjustments — Services Australia
8. [8]
   Access to super for members with a terminal medical condition and deceased estates — Australian Taxation Office (ATO)
9. [9]
   Organisations you need to contact and Tell Us Once — GOV.UK
10. [10]
    Applying for probate — GOV.UK