Palliative Care and End of Life Care Teams, Explained in Plain English

By Len Burgess, Senior Care Advisor · Published 3 June 2026

Palliative care and end of life care: what they actually mean, who is on the team, how the two differ, and how to make sure your relative gets the right support at the right time.

The latest post in our Care Jargon Buster series covers two of the most misunderstood and most emotionally weighted terms in the care sector. Palliative care and end of life care: what they actually mean, who is on the team, how the two differ, and how to make sure your relative gets the right support at the right time.


If your relative has been told they need palliative care, or that the team is "moving to end of life care," your first reaction is almost always the same: a wave of fear about what those words mean. Most families assume the worst, and most families are at least partly wrong.


This post explains what palliative care and end-of-life care actually are, who the teams involved are, how they work in care homes, nursing homes, and at home, and how to access them. It is written for families navigating one of the most difficult conversations of their lives.


A short, important note before we go further. Palliative care is not the same as dying soon. End-of-life care is a specific stage within palliative care.


We unpack the difference straight away, because misunderstanding it is one of the most common sources of unnecessary distress for families.


What is palliative care, and how is it different from end-of-life care?

Palliative care is the term the NHS and the World Health Organisation use for the approach that improves the quality of life of people facing a serious or life-limiting illness, and supports their families. It focuses on managing symptoms (pain, breathlessness, nausea, anxiety), supporting emotional and spiritual needs, and helping people live as fully and as comfortably as possible.


The key point is that palliative care can begin years before the end of life. Someone newly diagnosed with advanced cancer, Parkinson's, motor neurone disease, heart failure, COPD, or dementia might be referred to a palliative care team early to help manage symptoms, plan, and support their family. Many people live for months or years receiving palliative care, often alongside active treatment.


End-of-life care is a specific stage within palliative care. The NHS defines it as palliative care for people who are in the final 12 months of their life. Within end-of-life care is an even more specific stage, sometimes called the last days of life or terminal care, which refers to the final hours, days, or weeks.


So the simple version is this. Palliative is the umbrella. End of life is the part of palliative care that happens in roughly the last year. The last days of life are a part of end-of-life care that happens at the very end. All three are about quality of life and comfort, not about giving up on the person.


A few essentials to lock in:



How does the palliative care team actually work?

The palliative care team is rarely a single team in one place. In practice, your relative's care is likely to involve several teams and individuals working together. Below are the main ones, with what each does.


The GP and the district or community nurse. For most people receiving palliative care at home or in a care home, these are the day-to-day lead clinicians. The GP oversees the medical care, prescribes medications including those for pain and symptom control, and makes referrals to specialist services. The district or community nurse coordinates much of the practical nursing care, visits at home, and brings in other services as needed.


Specialist palliative care nurses. Nurses with advanced training in palliative care often work in community palliative care teams linked to local hospices. They provide specialist advice on managing complex symptoms, support families, and help coordinate care. They visit people at home or in care homes, and can be referred by any of the day-to-day clinicians.


Hospice teams. Hospices in the UK provide three things: short-stay specialist inpatient care for complex symptom management, day services and outpatient clinics, and community palliative care services that visit people at home and in care homes. Most hospice services are free for patients and families.


Marie Curie nurses and healthcare assistants. Provided by the Marie Curie charity, often as overnight nursing at home for people in the last weeks of life. Referred in by the GP or district nurse, the service is free for families.


Macmillan nurses. Provided by Macmillan Cancer Support, these specialist nurses primarily support people with cancer, including those receiving palliative care. They provide information, emotional support, and specialist nursing advice, although they do not usually carry out routine nursing tasks. Free service.


Hospital palliative care teams. Most hospitals now have a specialist palliative care team that supports inpatients with life-limiting illness. They can also be involved in discharge planning to home or a care home with appropriate palliative care support in place.


Care home palliative care leads. In a care home or nursing home, day-to-day palliative care is delivered by the home's own staff, ideally led by a registered nurse with specific palliative care training. The home should also have routes to external specialist support through the Enhanced Health in Care Homes (EHCH) framework.


Allied Health Professionals (AHPs). Physiotherapists, occupational therapists, speech and language therapists, and dietitians all have specific palliative care roles, including comfort positioning, managing breathlessness, supporting safe swallowing, and helping with daily life when someone is no longer fully mobile.


Spiritual, emotional, and social care. Chaplains, bereavement counsellors, social workers, and trained volunteers (often provided by hospices) all play a role in supporting the person and their family beyond the strictly medical.


How does this apply to me?

These are the five questions families ask most often about palliative care and end-of-life care teams.


1. Does palliative care mean the end is near?

No, and this is the most important thing to understand about it. Palliative care can begin months or years before the end of life. The point of palliative care is to manage symptoms and improve quality of life for anyone living with a serious or life-limiting illness, regardless of how long they have left.


Many families are shaken when they hear the word "palliative" because they assume it means the doctors have given up. They have not. Palliative care can run alongside continuing treatment, including chemotherapy, dialysis, medications for heart failure, or any other ongoing care. It is added to the existing care, not a replacement for it.


The "end of life" stage is more specific. It refers to roughly the final 12 months of life, and within that, the final days are sometimes called "the last days of life" or "terminal care." If your relative is being referred to palliative care for the first time, the right question to ask is: "What stage of palliative care do you mean, and what is the expected trajectory?" The answer will give you a much clearer picture than the word "palliative" on its own.


2. How long before death is palliative care typically needed, and how long can end-of-life care last?

These two questions are slightly different.


Palliative care can begin from the point of diagnosis of any life-limiting illness, even where life expectancy is years rather than months. It is not unusual for people with conditions like motor neurone disease, advanced Parkinson's, or heart failure to receive palliative care input for two, three, or even more years.


End-of-life care is defined as care in the final 12 months of life. In practice, the trajectory varies enormously by condition. Some people are recognised as being in their final year very clearly. Others move into the end-of-life stage more gradually, particularly with conditions like dementia or frailty.


The last days of life (sometimes called terminal care) usually refer to the final hours or days, when active dying has begun. This is when the focus shifts almost entirely to comfort and presence.


If you want to understand where your relative is in this trajectory, the most useful person to ask is their GP or specialist nurse. The honest answer is often that nobody can predict exactly, but most professionals can give you a reasonable framing.


3. Who can access palliative care, and how is it arranged?

Anyone with a life-limiting illness can access palliative care through the NHS. This includes (but is not limited to) advanced cancer, motor neurone disease, advanced heart failure, advanced respiratory disease, advanced kidney failure, advanced liver disease, advanced dementia, and frailty.


There is no formal eligibility test. The route in is usually through the GP or the specialist team managing your relative's main condition (cancer team, cardiology team, respiratory team, and so on). Either can refer to specialist palliative care services in your area.


For people in care homes and nursing homes, palliative care should already be built into the home's day-to-day work, with external specialist input arranged through the EHCH framework when needed. Care home staff are increasingly trained in palliative care principles, and the best homes will have specialist nurse links established.


For people at home, the GP and district nurse are usually the first point of contact, with referrals onward to specialist nurses, Marie Curie, hospice community teams, and so on. The NHS Continuing Healthcare Fast Track pathway is also worth knowing about, which we cover in the next question.


4. What is NHS Continuing Healthcare Fast Track, and when does it apply?

Fast Track Continuing Healthcare (CHC) is a specific pathway designed for people who are rapidly deteriorating or who are entering the end-of-life stage. It allows the NHS to take over the full cost of care urgently, without the usual lengthy CHC assessment process.


Fast Track CHC is not means-tested. It is free. And it can fund either care home fees or home care, depending on where the person wants to be cared for.


To access Fast Track, a clinician (usually a doctor or specialist nurse) completes a specific Fast Track tool, which the local Integrated Care Board (ICB) is expected to process urgently, often within 48 hours. Once approved, the ICB arranges and pays for care immediately.


Fast Track is one of the most important and most underused parts of the system. Many families discover it too late, after weeks of self-funding care that could have been NHS-funded. If your relative is rapidly deteriorating or has been told they are in the final stages of a life-limiting illness, ask explicitly about Fast Track. The GP, hospital team, or specialist palliative care nurse can initiate it. We cover the wider CHC system in detail in our separate guide.


5. What happens in the last days of life, and what does the team do then?

The last days of life are the final period before death, which can range from hours to a few weeks, depending on the person and the condition. The team's focus during this time is on comfort, dignity, and supporting the family.


Practically, this often involves:



Common physical changes in the last days include increasing sleepiness, reduced eating and drinking, changes in breathing patterns, and reduced responsiveness. These are normal parts of the dying process. A good palliative care team will explain what to expect so the family is not surprised or distressed by changes they have not been prepared for.


In any setting, the GP, district nurse, specialist palliative care nurse, and home staff will work together to provide this care, with hospice teams, Marie Curie, or hospital teams brought in as needed. The aim is always that the person dies comfortably, in the place they have chosen, wherever possible, with the people they love around them.


The takeaway

Palliative care is one of the most misunderstood and most valuable parts of the UK care system. The word frightens families because they assume it means dying soon. In most cases, it means focused, expert support to manage the symptoms and the wider needs of someone living with a serious illness, alongside whatever else is happening with their care.


Three practical takeaways. Do not be afraid of the word palliative: ask the team to explain what stage they mean and what the trajectory looks like. Ask about NHS Continuing Healthcare Fast Track if your relative is rapidly deteriorating or entering the end-of-life stage, because it can fully fund care home fees or home care without means testing and without delay. And ask any care home you are considering about its palliative care arrangements: which specialist nurses they work with, what training their staff have, and how they support families during the dying process.


Our funding calculator can show you how the costs of care work alongside CHC (including Fast Track), FNC, council support, and the means test. Our wider Jargon Buster series explains every term you will come across, including detailed guides to CHC, the multidisciplinary team, the Enhanced Health in Care Homes framework, and the Allied Health Professionals who play a quiet but essential role in palliative care.


This article is for general guidance only and reflects how palliative care and end-of-life care services work in England as of 2026. Services vary by area, and access to specialist palliative care, Marie Curie, and hospice support depends on local provision. For specific advice on accessing palliative care for your relative, contact their GP, the care home's registered manager, or the Marie Curie support line on 0800 090 2309 (free, eight days a week).

Sources

Frequently asked questions

What is the difference between palliative care and hospice care?

These are related but not the same. Palliative care is the broad approach to managing symptoms and improving quality of life for anyone with a serious or life-limiting illness, regardless of where they live or who provides it. Hospice care is one specific form of palliative care, delivered by a hospice organisation. Hospices in the UK provide three types of service: short stays for specialist symptom management or end-of-life care (typically a few days to a few weeks), day services and outpatient clinics, and community palliative care services that visit people at home or in care homes. Most hospices are charities, and most services are free. Importantly, going into a hospice does not always mean staying until death. Many people have a short stay for symptom management and then return home or to a care home. The hospice is a place and a service; palliative care is the approach. You can receive palliative care without ever entering a hospice, and many people do.

How do I talk to my relative about palliative care?

This is one of the hardest conversations any family will have, and there is no single right way to do it. A few principles help. Be honest but gentle: most people in this situation already sense more than their families assume, and pretending nothing is changing usually adds confusion rather than comfort. Follow their lead: some people want to know everything immediately, and some do not, and respecting that is more important than getting all the information out at once. Focus on what palliative care actually offers: better symptom management, more support, expert advice, a team that can be called when things get difficult, not "giving up." Involve the team: GPs, specialist nurses, Marie Curie, and Admiral Nurses (for dementia) are all experienced at having these conversations and can support both you and your relative. Plan ahead while there is still time: things like Power of Attorney, advance decisions, and preferred place of care are easier to discuss earlier than later. Allow time and silence: difficult conversations are not single events; they happen across multiple shorter conversations over weeks and months.

What is advance care planning, and should my relative do it?

Advance care planning is the process of recording someone's wishes about their future care, particularly the care they want or do not want as their condition progresses. It typically includes: preferred place of care (home, care home, hospice, hospital), treatment preferences (whether to be admitted to hospital if seriously unwell, whether to accept CPR, whether to accept feeding tubes if eating becomes difficult), and personal wishes (faith and spiritual care, who to contact, what music or company they want, where their important documents are). Two specific legal documents are particularly important. An Advance Decision to Refuse Treatment (ADRT), sometimes called a "Living Will," is legally binding and lets someone refuse specific medical treatments in advance, in case they lose capacity to decide for themselves at the time. A Lasting Power of Attorney (Health and Welfare) allows a named person to make health and care decisions on someone's behalf if they lose capacity. Both can be set up while your relative still has mental capacity. The GP, hospital team, specialist palliative care nurse, or a solicitor can support the process. The earlier this is done, the more it protects everyone.

How does palliative care interact with NHS Continuing Healthcare?

Two ways. First, Fast Track CHC (covered in the main post above) is specifically designed for people who are rapidly deteriorating or near the end of life, and it can be in place within days. Second, standard CHC also commonly applies to people with advanced palliative care needs whose primary need is now a health need rather than a social care need. Many people start with Fast Track CHC for a period of stability, and some are then transitioned to standard CHC if they live longer than expected, with a full Decision Support Tool assessment carried out at that point. The palliative care team's records and reports are valuable evidence at any CHC assessment. If your relative is receiving palliative care and the care costs are becoming a significant concern, ask the palliative care team or the GP about Fast Track CHC. We cover the wider CHC system, the Decision Support Tool, and the multidisciplinary team in detail elsewhere in this series.

What support is available for the family after death?

Bereavement support is part of the palliative care system, although it is often underused because families do not know how to access it. Several routes are available. Hospice bereavement services are often free and open to families, even if their relative did not die in the hospice itself, including individual counselling, peer support groups, and bereavement cafes. Marie Curie offers a free bereavement support service through a national helpline and online resources. Cruse Bereavement Support is the UK's largest bereavement charity, offering free counselling and support across the country. GPs can refer to local counselling and mental health services where bereavement is leading to clinical levels of distress. For children and young people, Winston's Wish and Child Bereavement UK offer specialist support. Workplace support is also worth checking: many employers now offer paid bereavement leave and counselling through Employee Assistance Programmes. The most important thing to know is that asking for help is normal, expected, and welcome at any point, whether the death was recent or years ago.