United Kingdom – End of Life Issues

What palliative and hospice care is available in the UK?

The UK is home to one of the most developed hospice and palliative care networks in the world, yet it operates on a funding model that often takes newcomers by surprise. In contrast to countries such as France or Germany, where specialist end of life provision sits squarely within a state-funded health system, the UK’s hospice sector grew from charitable and philanthropic roots and has remained largely independent of the NHS ever since.

The majority of hospices were established through voluntary giving and private philanthropy and continue to be charity-led and independently operated. Around a third of their total income, however, comes from statutory sources — the NHS and central government. In practical terms, this means hospices depend heavily on fundraising campaigns, legacy gifts, and community generosity to keep their doors open.

In England, the commissioning of palliative and end of life care services — including hospice provision — falls primarily to Integrated Care Boards (ICBs). The Health and Care Act 2022 explicitly added palliative care to the list of services that ICBs are legally obliged to commission for their local populations. While this represented a meaningful step forward, real-world commissioning continues to vary considerably from one area to another.

The reach of hospice care across England is far from uniform. Because the hospice movement expanded organically through local charitable effort rather than strategic planning, the geographic spread of services reflects that uncoordinated history. Funding channelled through Integrated Care Boards — whether via grants or contracts — covered 40% of independent adult hospices’ service expenditure in 2023–24, amounting to more than £400 million. Nevertheless, the gap between what statutory funding provides and what hospices actually need remains substantial.

Because the sector was never built around demographic or geographic planning, people living in rural communities or areas of social deprivation often face the steepest barriers to hospice access. That said, the majority of palliative and end of life care in the UK is still delivered by NHS staff and services, which are commissioned to meet local need.

Financial pressures across the sector are acute: close to two thirds of adult hospices reported a deficit in 2023–24, with income from both fundraising and government contributions in decline at a time when demand is projected to grow. Some hospices have already begun scaling back services in response. Acknowledging this strain, the Department of Health and Social Care announced in December 2024 a one-off £100 million capital fund, spread across 2024–25 and 2025–26, for adult and children’s hospices.

Expats who are registered with a GP and entitled to NHS treatment can generally access NHS-funded palliative care. Hospice inpatient beds, day services, and hospice-at-home care are typically provided at no cost to patients, though what is actually available depends on where you live. For a clear picture of local provision, contact your ICB directly or consult the NHS hospice care guidance. National charities such as Marie Curie and Sue Ryder also deliver direct nursing and support services across the UK.

How does end of life planning work in the UK — wills, advance directives, and power of attorney?

The UK offers a well-established legal structure for planning ahead at the end of life. Three instruments form the backbone of this framework: a will, an advance directive (sometimes called a living will), and a Lasting Power of Attorney (LPA). Each fulfils a distinct purpose and is subject to its own formal requirements. Foreign nationals residing in the UK should be aware that once you are habitually living here, domestic law governs these documents — making it wise to consult a locally qualified solicitor at the outset.

A living will — formally referred to as an advance decision — is a legally binding document in which you record which medical treatments you would refuse in specified future circumstances. Healthcare professionals are legally required to honour a valid advance decision, provided it satisfies the relevant criteria. In England and Wales the document is also referred to as an Advance (Medical) Decision, and equivalent provisions exist under Scots law.

An advance decision to refuse treatment (ADRT) must be set down in writing if it covers refusal of life-sustaining treatment, and it may specify the particular circumstances in which that refusal applies. To make one, you must be aged 18 or over and have mental capacity at the time. The process involves completing a form, printing and signing it in the presence of a witness — anyone may serve as witness, including a family member. A solicitor is not a legal requirement, although professional input considerably reduces the likelihood that the document will later be contested.

The Mental Capacity Act 2005 introduced the Lasting Power of Attorney, a legal instrument that authorises a nominated person — the attorney — to take decisions about health and welfare or finances and property when the donor no longer has the mental capacity to do so. Two distinct forms exist: an LPA for Property and Financial Affairs, and an LPA for Health and Welfare. Each covers very different ground.

An LPA for Health and Welfare empowers the attorney to make choices about social care and medical treatment on the donor’s behalf, including decisions about life-sustaining treatment. Before either type of LPA can be used, it must be registered with the Office of the Public Guardian in England and Wales, or its Scottish counterpart.

One important interaction to be aware of: if you have both an advance decision to refuse treatment and a health and welfare LPA, they may conflict with each other. In such cases, the document created most recently takes precedence. For expats who have drawn up both instruments at different points in time, reviewing them together with a solicitor is strongly advisable.

Regarding wills: any person aged 18 or over may make a valid will in the UK, regardless of their nationality or immigration status. The will must be written, signed by the person making it (the testator), and witnessed by two independent witnesses who are not named beneficiaries. Foreign nationals should note that a will made in another country may be recognised in the UK if it satisfies either the formal requirements of the jurisdiction where it was drawn up or those of UK law — but this is legally complex territory. Seek guidance from a UK-qualified solicitor or the GOV.UK guidance on making a will. If a power of attorney was granted in another country, its enforceability in the UK turns on whether it meets the requirements of the Private International Law (Implementation of Agreements) Act 2020 and relevant case law — specialist legal advice is essential.

What are the laws around euthanasia and assisted dying in the UK?

As of March 2026, the legal landscape surrounding assisted dying in the UK is in the middle of a period of profound change — although the law itself has not yet been altered. The position differs between the four nations that make up the UK, and expats with a personal interest in this area should keep a close eye on ongoing developments.

Under the Suicide Act 1961, assisting another person to take their own life is a criminal offence in England and Wales, carrying a maximum penalty of 14 years’ imprisonment. Anyone who helps a terminally ill person bring about their own death — regardless of their nationality — currently exposes themselves to potential investigation, prosecution, and imprisonment under this legislation.

However, the law is on the cusp of a landmark shift. On 20 June 2025, the House of Commons voted in favour of legalising assisted dying in England and Wales. The Terminally Ill Adults (End of Life) Bill would permit adults who are expected to die within six months to receive assistance in ending their lives. Eligibility would be restricted to adults over 18 in England and Wales with a terminal prognosis of less than six months.

Under the proposed framework, any request for an assisted death would need to be approved by two separate doctors and a panel comprising a social worker, a senior legal figure, and a psychiatrist. Eligibility would also require that the person be registered as a patient with a GP practice in England or Wales — a condition that has direct implications for expats, since those not registered with a GP would be excluded even if the legislation passes.

At the time of writing, the bill is being subjected to detailed scrutiny by the House of Lords. The Lords may debate, delay, and propose amendments, but they have limited power to permanently block legislation that has been approved by elected Members of Parliament in the Commons. Although no firm implementation timetable has been set, the terms of the bill stipulate that it must come into force within four years of receiving Royal Assent.

The bill covers England and Wales only; it will have no effect in Northern Ireland or Scotland. Scotland was conducting its own legislative process, but the Scottish Assisted Dying for Terminally Ill Adults Bill was rejected at stage three in the Scottish Parliament in March 2026. Expats who have relocated from a country where assisted dying is already legal — such as the Netherlands, Belgium, Canada, or certain US states — need to understand that such practices remain unlawful throughout the UK for now. The current status of the legislation can be tracked at the UK Parliament’s official bill tracker.

What happens to a foreign national’s body when they die in the UK?

The death of a foreign national in the UK sets in motion a process that involves both UK legal obligations and the requirements of the deceased’s home country. Navigating this dual framework can be demanding, and engaging a funeral director with specialist experience in international repatriation at the earliest opportunity is strongly recommended.

The starting point is obtaining a death certificate from the local register office (see the step-by-step section below for full details). Once the death has been formally registered and any coroner’s inquiry has been concluded, the next of kin or appointed representative must decide whether to arrange local burial, cremation in the UK, or repatriation of the remains to the deceased’s country of origin.

Repatriation of remains typically requires the following documentation: a UK death certificate; a certificate from the relevant authority confirming the cause of death; an embalming certificate (required by most countries for bodies transported by air); a certificate from the funeral director confirming that the coffin contents comply with international transport standards; and authorisation from the relevant authorities in the destination country, usually obtained with assistance from that country’s embassy or consulate in the UK. The deceased’s home country embassy or consulate should be informed promptly — they can advise on the specific documentation each country requires, which varies considerably.

The cost of repatriation depends heavily on the destination. As a general guide, returning remains to a European country might cost from £2,000–£5,000 or more, while repatriation to destinations outside Europe can involve significantly higher expenditure (as of 2024 — confirm current pricing with a licensed funeral director). Some life insurance and travel insurance policies include repatriation cover, so reviewing any existing policies should be an early priority. Official guidance is available through the GOV.UK guidance on bringing a body to the UK and through local council pages.

Local burial or cremation is a practical and frequently more affordable alternative to repatriation. There are no legal barriers to foreign nationals being buried or cremated in the UK. Religious and cultural requirements — for example, the need for burial within 24 hours, which is customary in Islamic and Jewish traditions — can generally be met, though advance planning with an experienced funeral director is advisable. Dedicated Muslim and Jewish burial grounds exist in most major UK cities. Non-religious services are available through organisations such as the British Humanist Association.

Where a coroner becomes involved (see below), both repatriation and local burial may be delayed until any post-mortem examination or inquest is finalised. A Coroner’s Certificate is required before a body may be removed from England, Wales, or Northern Ireland. Scotland operates a different system under the authority of the Procurator Fiscal.

What are the local customs and cultural practices around death in the UK?

The UK’s remarkable cultural diversity means that death rituals and mourning practices take many forms. No single tradition dominates, as customs are shaped by religion, regional heritage, family background, and individual preference. Nevertheless, there are broad cultural norms that most expats are likely to encounter.

Secular or broadly Christian funerals remain widespread, even among families with little active religious affiliation. A funeral service is typically held within one to two weeks of the death, followed by either burial or cremation. Cremation has become the predominant choice in the UK, now accounting for roughly 80% of all funerals. A gathering of some kind — often called a wake or reception, held at a pub, community hall, or the family home — usually follows the service, giving mourners the opportunity to share food, drink, and recollections of the person who has died.

There is no officially prescribed period of mourning in secular British culture, though wearing black or dark-coloured clothing to a funeral is standard practice. Flowers are a common gesture, sent either to the family or to the funeral venue, although some families ask that donations be made to a nominated charity instead. Sending a handwritten condolence card is a widely observed tradition. Most employers offer a degree of compassionate leave to bereaved staff, though the number of days granted varies between workplaces.

Religious communities observe their own distinct customs. In the UK’s substantial Muslim community, burial takes place as swiftly as possible following death, preceded by ritual washing and shrouding of the body. Jewish tradition similarly emphasises prompt burial, and is followed by shiva — a formal mourning period observed at home. Hindu and Sikh communities typically favour cremation, often accompanied by specific preparatory rituals. Some communities may wish for the body to be taken to a particular religious centre before the funeral.

Expats attending a British funeral for the first time may notice that the tone is more composed and restrained than in some other cultures — grief is present and acknowledged, but the prevailing atmosphere tends toward quiet dignity. Conversely, those from cultures where emotional restraint is the norm may find the emotional openness of certain communities here unexpected. There is no expectation that friends or non-family members, including expats, fulfil any particular ceremonial role beyond attending and expressing condolences to those closest to the deceased.

What must you do when someone dies in the UK — the official steps?

The administrative procedures that follow a death in the UK are governed by law and must be observed carefully. Missing the required registration deadline can create both legal and practical difficulties. The steps below apply primarily to England and Wales; Scotland and Northern Ireland follow broadly similar processes but with some procedural distinctions. Always verify current requirements with the local register office and, where the deceased was a foreign national, with the relevant embassy or consulate (as of 2025).

1. Obtain a medical certificate of cause of death (MCCD). Where a death was anticipated, the GP or attending doctor will issue an MCCD, which is the document needed to register the death. If the death was sudden, unexplained, or the cause is unclear, the doctor is required to refer the matter to the coroner in England, Wales, and Northern Ireland, or to the Procurator Fiscal in Scotland. A coroner’s investigation may add time to the process before registration can proceed.
2. Register the death with the local register office. In England and Wales, registration must take place within 5 days of the death occurring (as of 2025). Scotland allows 8 days; Northern Ireland also requires registration within 5 days. Registration must be completed in person at the register office serving the area in which the death took place. The person attending to register — known as the informant — may be a relative, someone present when the death occurred, or in certain circumstances the occupier of the premises. You will need the MCCD and any identification documents belonging to the deceased that are available.
3. Obtain certified copies of the death certificate. When registering the death, request as many certified copies of the death certificate as you are likely to need. Multiple copies are typically required — for probate proceedings, banks and financial institutions, pension providers, insurers, and the home country embassy. A fee applies per certified copy; confirm the current amount with the register office (as of 2025).
4. Notify the coroner if required. Where a death is referred, the coroner will determine whether a post-mortem examination or a formal inquest is necessary. An inquest can last months or, in some cases, considerably longer. The coroner’s office will keep you informed about what paperwork is required and when the body may be released for burial, cremation, or repatriation.
5. Notify the deceased’s home country embassy or consulate. If the deceased held foreign nationality, contact their home country’s embassy or consulate in the UK without delay. They can provide guidance on reporting obligations back in the home country, help assemble the documentation needed for repatriation, and support efforts to inform relatives living abroad. A directory of foreign embassies in the UK can be found via the GOV.UK foreign embassy directory.
6. Notify the relevant UK institutions. Inform HM Revenue & Customs (HMRC) for tax purposes; the Department for Work and Pensions (DWP) if the deceased was receiving state benefits or a state pension; any private pension schemes; banks and financial institutions; and the deceased’s employer where applicable. The government’s Tell Us Once service lets you notify multiple government departments in a single step.
7. Apply for a grant of probate (if required). If the deceased left a will and held assets in their own name, probate will ordinarily be required before those assets can lawfully be distributed. Probate is the formal legal process through which a court confirms the will’s validity and authorises the named executor to act on behalf of the estate. Where no valid will exists — a situation known as intestacy — an application for Letters of Administration must be submitted instead. Both types of application are handled through the Probate Registry.
8. Arrange burial, cremation, or repatriation. Once the death has been registered and the coroner — if one was involved — has released the body, you may proceed with formal funeral arrangements through a licensed funeral director. If you intend to repatriate the remains, ensure that all required documentation described in the section above has been gathered before transport is arranged.

How does inheritance and estate law work in the UK for expats?

UK inheritance law governs assets held in the UK regardless of the nationality of the person who has died or of those set to inherit. For expats, this can create an overlap with the inheritance laws of their home country, and obtaining advice from a solicitor who specialises in cross-border estates is strongly advisable.

Unlike EU member states, the UK is not bound by the EU Succession Regulation (Brussels IV), which means it does not automatically apply the law of the deceased’s habitual residence to their entire estate. Instead, UK law broadly applies English or Welsh law — or Scots law — to immovable property (real estate) located in the UK, and the law of the deceased’s domicile to movable property such as bank accounts and investments. “Domicile” is a nuanced legal concept that is distinct from both residence and nationality — a specialist solicitor can advise on how it is assessed in your particular circumstances.

Inheritance Tax (IHT) is levied on the estate of a person who was domiciled in the UK at the time of death, and also on UK-situated assets belonging to individuals not domiciled here. As of 2025, the principal figures are:

• A nil-rate band of £325,000 — no IHT is due on the first £325,000 of an estate’s value.
• A residence nil-rate band of up to £175,000 may be available where the deceased’s primary home passes to direct descendants (as of 2025).
• The standard IHT rate stands at 40% on the portion of the estate exceeding the applicable threshold.
• Transfers between spouses or civil partners are generally exempt from IHT, provided both parties are domiciled in the UK.

These figures should always be confirmed against HMRC’s official Inheritance Tax guidance, since thresholds and the rules governing them can be adjusted at each budget. The UK has bilateral double-taxation agreements on inheritance with a number of other countries, which may limit or eliminate the risk of the same assets being taxed twice. A qualified tax adviser can confirm whether such a treaty applies to your home country.

When a person dies without leaving a valid will — a state known as intestacy — the UK’s intestacy rules determine how the estate is divided. In England and Wales, surviving spouses or civil partners take priority, followed by children, then grandchildren, then more distant relatives. A foreign national who dies intestate in the UK will have their UK estate distributed according to UK intestacy rules, irrespective of what their home country’s law might have provided. For expats in particular, making a valid UK will is therefore one of the most important steps you can take.

What practical steps should expats take to prepare for end of life in the UK?

Planning for end of life while living in another country requires somewhat more thought than it would at home, simply because your assets, family members, and legal documents may be spread across more than one jurisdiction. The checklist below covers the most critical areas to address.

• Make or update a will that is valid in the UK. A will drawn up in your home country may or may not be recognised here. Engage a UK-qualified solicitor to prepare or review your will. If you hold significant assets in both the UK and your home country, having separate wills for each jurisdiction may be appropriate — your solicitor can draft them so they do not inadvertently revoke one another.
• Set up a Lasting Power of Attorney. An LPA designates someone you trust to manage your healthcare decisions or financial affairs if you lose mental capacity. It must be registered with the Office of the Public Guardian before it can be used — the registration process takes time, so do not leave it until a crisis arises.
• Draw up an advance directive if you have strong preferences about medical treatment. A living will or advance directive records your wishes regarding medical interventions in the event that you are unable to communicate them yourself. Having one in place means your healthcare choices will be respected when it matters most.
• Make sure the right people know where your key documents are kept. Your will, LPA, advance directive, life insurance policies, pension documentation, and bank account details should all be accessible to whoever may need to act on your behalf. Tell family members or trusted contacts where to find them.
• Review your life insurance and health insurance cover. Check whether your life insurance policy pays out to beneficiaries in the UK and whether it includes repatriation of remains. If you have private health insurance, confirm what end of life and palliative care services it covers. If you rely on the NHS, take the time to understand what palliative care is commissioned in your local area.
• Register with your home country’s embassy or consulate. Many governments run voluntary registration schemes for nationals living abroad — for example, the US STEP programme or equivalent services offered by other countries. Registration makes it far easier for your home government to support your family if you die while abroad.
• Consider a prepaid funeral plan or make your wishes known in writing. Prepaid funeral plans in the UK allow you to lock in costs at today’s prices and relieve your family of difficult decisions at an already stressful time. Ensure any plan is with a provider regulated by the Financial Conduct Authority (FCA), which has overseen the sector since 2022.
• Work with the right professionals. For wills and LPAs, use a UK-qualified solicitor — ideally one accredited by the Society of Trust and Estate Practitioners if your estate crosses borders. For tax planning, engage a financial adviser or tax consultant with cross-border and expat expertise. When making funeral arrangements, look for a director who is a member of the National Association of Funeral Directors (NAFD) or the Society of Allied and Independent Funeral Directors (SAIF).

Frequently Asked Questions

Is a will I made in my home country valid in the UK?

A will executed outside the UK may be recognised here if it meets the formal requirements of either the jurisdiction in which it was made or those set out under UK law. That said, the interplay between different legal systems is complex — particularly where estates span multiple countries. You should ask a UK-qualified solicitor to review any foreign will to confirm it is valid and consistent with UK law. It would be unwise to assume that the UK Probate Registry will automatically accept it without question.

What happens if someone dies in the UK without a will?

Where a person dies intestate — without a valid will — in the UK, the estate passes according to the statutory intestacy rules. In England and Wales, a surviving spouse or civil partner takes first priority, followed by children, grandchildren, and progressively more distant relatives. Unmarried partners have no automatic entitlement under intestacy rules, however long they may have lived together. This is a significant exposure for expat couples who have not formalised their relationship under UK law.

Can expats access NHS-funded palliative care?

Expats who are lawfully resident in the UK and registered with a GP are generally entitled to NHS care, which includes NHS-commissioned palliative and end of life services. Eligibility for NHS treatment rests on ordinary residence in the UK — it is not determined by nationality or immigration status. The availability of specialist hospice services, however, varies considerably by area. Speak to your GP or local Integrated Care Board to find out what is on offer near you, and consult the NHS end of life care pages for further information.

How do I arrange repatriation of a family member’s remains from the UK?

Repatriation requires you to coordinate between a UK-based funeral director with international experience, the local register office for death certificates, the coroner’s office where relevant, and the embassy or consulate of the deceased’s home country in the UK. The embassy can advise on the specific paperwork required at the destination end. Documents typically needed include a UK death certificate, a cause of death certificate, confirmation of embalming, and a sealed coffin certificate. Begin gathering documentation as early as possible, as the process can take time. Speak to a funeral director for up-to-date cost estimates, which vary widely depending on destination.

What should I do if a family member dies abroad (outside the UK) while I am in the UK?

If a family member dies outside the UK, you will need to engage with the authorities in the country where the death occurred. If the deceased was a UK national, contact the UK embassy or consulate in that country for consular support. If they were a foreign national who died abroad, their home country embassy is the appropriate first point of contact. The UK’s Foreign, Commonwealth & Development Office (FCDO) operates a helpline and offers detailed guidance for cases involving British nationals who die overseas — see GOV.UK for current information.

Is assisted dying currently legal in the UK?

Assisting another person to end their life remains a criminal offence in England and Wales under the Suicide Act 1961, with a maximum custodial sentence of 14 years. The House of Commons voted on 20 June 2025 to legalise assisted dying in England and Wales, but the resulting bill is still being scrutinised by the House of Lords as of March 2026 and has not yet become law. The current prohibition therefore remains in force, and the proposed legislation would not extend to Scotland or Northern Ireland in any event. You can follow the bill’s progress at the UK Parliament bill tracker.

Does the UK charge inheritance tax on estates left by foreign nationals?

UK Inheritance Tax applies to assets situated in the UK regardless of the deceased’s nationality. Where the deceased was domiciled in the UK at the time of death, their worldwide estate may fall within the scope of IHT. The standard nil-rate band is £325,000, and a rate of 40% applies to the value of the estate above that threshold (as of 2025). Bilateral double-taxation treaties with certain countries may reduce or eliminate the risk of the same assets being taxed in two jurisdictions. Always confirm current rules and thresholds with HMRC or a qualified tax professional.

Does a Lasting Power of Attorney from another country work in the UK?

A power of attorney issued in another country does not carry the same automatic legal weight as a UK Lasting Power of Attorney. Whether a foreign instrument of this kind will be recognised in the UK depends on its precise form and content, together with the applicable rules of private international law. In practice, UK banks, healthcare providers, and other institutions frequently decline to act on a foreign power of attorney. If you intend to live in the UK for the long term, setting up a UK LPA registered with the Office of the Public Guardian is the most reliable course of action. Seek advice from a solicitor with expertise in cross-border estate planning.