Cross-Border Terminal Illness & Advance Care Checklist: UK & France

1. 1

   Coordinate Home Palliative Care in France and 100% ALD Coverage

   Medical coordination in France begins with your relative's registered general practitioner (médecin traitant) or the specialist hospital team overseeing their care [1][2]:

   • 100% long-term illness coverage (Affection de Longue Durée - ALD): Ask the doctor to establish or update a care protocol under the Affection de Longue Durée (ALD) scheme with the local Caisse Primaire d'Assurance Maladie (CPAM, the French local health insurance fund) so that medical consultations, nursing care, prescriptions, medical equipment, and medical transport linked to the condition are covered at 100% of the statutory French Social Security tariff [2].
   • Home hospitalisation (Hospitalisation à Domicile - HAD) and palliative care networks: To enable your relative to remain at home with complex or continuous care, the hospital doctor or médecin traitant can prescribe Hospitalisation à Domicile (HAD, full home hospitalisation) with the consent of the patient and family [1][2]. HAD coordinates medical and nursing care, pain management, specialist equipment, and psychological or social support at home with 100% coverage and direct third-party billing (tiers payant) for care included in the care protocol [1][2]. Alongside or prior to HAD, the doctor can refer your relative to a mobile palliative care team (équipe mobile de soins palliatifs - EMSP), the departmental care coordination hub (Dispositif d'Appui à la Coordination - DAC), or an inpatient specialist palliative care unit (Unité de Soins Palliatifs - USP) if hospital admission becomes necessary [1][3].
   • UK S1 healthcare cover and national support contacts: If your relative's healthcare cover in France is based on a registered UK S1 form (for example, as a UK State Pension recipient residing in France), their entitlement to French palliative care and HAD applies on the same terms as for any person insured with the Caisse Primaire d'Assurance Maladie, which operates an English-speaking helpline on 09 74 75 36 46 from within France or +33 9 74 75 36 46 from abroad (standard French helpline: 36 46 or +33 1 84 90 36 46) [2]. For guidance on end-of-life rights and regional services, you can contact the Centre National des Soins Palliatifs et de la Fin de Vie (National Centre for Palliative and End-of-Life Care) via its national helpline on 01 53 72 33 04 (switchboard 01 53 72 33 00) [3], or consult the national directory of palliative care networks and support associations maintained by the Société Française d'Accompagnement et de Soins Palliatifs (SFAP) on 01 45 75 43 86 or by email at [email protected] [4].
2. 2

   Draft Advance Directives and Appoint a Trusted Person in France

   While your relative is fully able to express their wishes, it is important to formalise two complementary medical documents under the French Public Health Code (Code de la santé publique, Claeys-Leonetti legal framework) [3][5]:

   • Appointing a trusted person (personne de confiance): This is a written document, dated and co-signed by your relative and the designated person, naming who the French medical team must consult first if the patient becomes unable to express their wishes [3][5]. The personne de confiance acts as the faithful spokesperson for the patient's wishes and convictions and may attend medical appointments with them; a family member residing in the United Kingdom can be appointed provided they sign their written consent and remain easily reachable [5].
   • Advance directives (directives anticipées): This written document, dated and signed by the adult patient, sets out their end-of-life medical wishes regarding the continuation, limitation, withdrawal, or refusal of disproportionate medical treatments and interventions [3][5]. Official templates are available on Service-Public.fr and from the Centre National des Soins Palliatifs et de la Fin de Vie [3][5].

   Keep both documents in an immediately accessible place at home, provide copies to the médecin traitant as well as the HAD or hospital care team, and upload them to your relative's digital health record (Mon Espace Santé) [1][5]. If a return to the United Kingdom for NHS hospice or hospital care is being considered, note that UK instruments such as an Advance Decision to Refuse Treatment (ADRT) or a ReSPECT plan follow separate UK rules and can be prepared in parallel [5][6].

3. 3

   Put Powers of Attorney and Legal Protection Mandates in Place in France and the UK

   In day-to-day banking and notarial practice, a power of attorney executed in one country is rarely accepted without delays or formal legalisation in the other. While your relative retains full legal capacity, it is strongly advisable to establish separate instruments in France and in the United Kingdom [6][7]:

   • For bank accounts and assets in France: For immediate day-to-day management of French bank accounts, ask the French bank directly for its internal bank power of attorney form (procuration bancaire) [7]. For broader administrative or property matters during your relative's lifetime, a French notary (notaire) can draw up a notarised power of attorney (procuration authentique); in addition, to prepare for any future loss of physical or mental capacity, your relative can sign a future protection mandate (mandat de protection future, executed either by notarial deed for comprehensive estate protection or by private deed using form Cerfa 13592), which takes effect only after a medical certificate of incapacity is issued by a court-approved doctor (médecin inscrit sur la liste du procureur de la République) and certified by the registry of the judicial court (visa du greffe du tribunal judiciaire) [7][8].
   • For assets, bank accounts, and pensions in the United Kingdom: If your relative holds bank accounts, pensions, or property in the UK, a power of attorney should be set up under the law of the relevant UK jurisdiction. Taking England and Wales as the primary example, your relative can create and register a Lasting Power of Attorney (LPA, available for Property and Financial Affairs and for Health and Welfare) with the Office of the Public Guardian on 0300 456 0300 from within the UK, +44 203 518 9639 from abroad, or by email at [email protected] [6]. (Separate statutory systems apply in Scotland via a Continuing and Welfare Power of Attorney and in Northern Ireland via an Enduring Power of Attorney [6].) Although France applies the Hague Convention of 13 January 2000 on the International Protection of Adults, relying directly on a UK LPA in France typically requires certified translations and legal verification that cause significant delays [6][7][8].
4. 4

   Check Carer's Leave and Financial Support Between France and the United Kingdom

   Leave entitlements and financial support for family caregivers depend on the country where the caregiver works and pays social security contributions:

   • In France (AJAP and congé de solidarité familiale): The daily end-of-life care allowance (Allocation journalière d'accompagnement d'une personne en fin de vie - AJAP), administered by the Centre National de Gestion des Demandes d'Allocations Journalières d'Accompagnement d'une Personne en Fin de Vie on 08 06 06 10 09, pays EUR 64.93 gross per day when a caregiver completely suspends work (or EUR 32.47 gross per day when switching to part-time work) for up to 21 days (which may be shared among multiple caregivers) to care at home - including under HAD - for a person in an advanced or terminal phase of illness [2]. However, AJAP is reserved for caregivers affiliated with the French social security system who suspend or reduce their professional activity (employees taking family solidarity leave or congé de solidarité familiale, self-employed workers, or jobseekers receiving benefits from France Travail), upon submission of form S3708 containing the medical attestation signed by the doctor in France [2]. A caregiver employed and insured solely in the United Kingdom cannot normally claim AJAP, though another family member or the personne de confiance covered under the French system may apply [2].
   • In the United Kingdom (Carer's Leave): For a family caregiver employed in Great Britain (England, Scotland, or Wales), the Carer's Leave Act provides a day-one statutory right to one week of unpaid Carer's Leave per 12-month period (which can be taken as a full week, individual days, or half-days) to provide or arrange care for a dependant with a serious long-term care need [9]. It is also advisable to check with the UK employer regarding contractual compassionate leave or temporary remote working arrangements from France [9].
5. 5

   Organise Bank Accounts, Cross-Border Succession, and Funeral Wishes

   While your relative retains full legal capacity, organising civil status, financial, and estate records across both jurisdictions will prevent administrative blocks later on:

   • Cross-border estate planning and wills (EU Succession Regulation / Brussels IV): Because your relative's habitual residence is in France, the EU Succession Regulation (Regulation (EU) No 650/2012) applies French succession law by default - including French forced heirship rules (réserve héréditaire) guaranteeing a minimum share of the estate to children - to the entire estate, unless your relative makes a will containing an express choice of law (professio juris) electing the law of their British nationality [8]. Note that for estates opened since 1 November 2021, Article 913 of the French Civil Code allows children who are citizens or habitual residents of an EU Member State to claim a compensatory levy (prélèvement compensatoire) against assets located in France if a chosen foreign law does not provide forced heirship protection [8]. You can consult a French notary via the official directory of the Notaires de France (+33 1 44 90 30 00) in coordination with a UK solicitor so that French and UK wills work together without inadvertently revoking one another [8].
   • Accounts, pensions, and civil status documents: Gather in a single accessible folder the British passport, French residence permit (carte de séjour), carte Vitale, birth and marriage certificates, French and UK bank account details, beneficiary clauses for French life insurance policies (contrats d'assurance-vie), and beneficiary nominations (expression of wish) for UK pension schemes (UK State Pension / International Pension Centre and private pensions) [2][8].
   • Funeral wishes: Discuss with your relative whether they wish to be buried or cremated locally in France (where burial or cremation takes place within strict statutory timeframes, generally between 24 hours and 6 working days - or up to 14 calendar days under current rules - after death) or repatriated to the United Kingdom, and check whether a French contrat obsèques or UK funeral plan is in place [8].

Official Authorities & Verified Contacts

Official Sources Checked by Clarvia

1. [1]
   End-of-life care, palliative care and home support (Fin de vie, soins palliatifs et accompagnement à domicile) — Portail national d'information pour les personnes âgées (pour-les-personnes-agees.gouv.fr)
2. [2]
   French Health Insurance - 100% ALD coverage, Home Hospitalisation (HAD), AJAP allowance and English-speaking helpline — Assurance Maladie (ameli.fr)
3. [3]
   Parlons Fin de Vie - Advance directives, trusted person (personne de confiance) and palliative care — Centre National des Soins Palliatifs et de la Fin de Vie
4. [4]
   National directory of palliative care and support structures (SFAP) — Société Française d'Accompagnement et de Soins Palliatifs (SFAP)
5. [5]
   Advance directives (directives anticipées) and appointing a trusted person (personne de confiance) — Service-Public.fr
6. [6]
   Make, register or end a lasting power of attorney — GOV.UK / Office of the Public Guardian
7. [7]
   Future protection mandate (mandat de protection future) and power of attorney — Ministère de la Justice (justice.fr)
8. [8]
   International successions, EU Succession Regulation and future protection mandate — Conseil supérieur du notariat (Notaires de France)
9. [9]
   Unpaid carer's leave — GOV.UK