Palliative and end of life care

Macmillan's nine outcomes are what people affected by cancer in the UK have told us matter most to them. Five of these outcomes in particular apply to people with palliative care needs:

  • care is personalised
  • care is coordinated 
  • people are helped to make informed decisions and plans 
  • carers are supported 
  • there’s an emphasis on quality of life. 

The last outcome, ‘I want to die well’, is central to our end of life strategy and our vision. Which is:

People who are nearing the end of their life will be supported to make decisions that allow them and their family or carers to be prepared for their death. Their care will be well coordinated and planned so that they die in the place and in the way that they have chosen.

Key themes

Our work mirrors the key themes identified for palliative and end of life care across the UK:
  • identification of people approaching the end of life and initiating discussions 
  • care planning 
  • coordination of care 
  • delivery of high quality services in all locations 
  • management of the last days of life 
  • support for carers, both during a person’s illness and after their death 
  • raising the profile of death and dying 
  • strategic commissioning  

Advance Care Planning

Encouraging people to put their affairs in order, plan, and make choices about their future care is important. We want to better support health and social care professionals to do this. We have produced a range of resources aimed at enabling professionals to feel more confident and better equipped when supporting people to make advance care plans.

These include our Advance Care Planning e-learning course, designed specifically for professionals across a range of roles supporting people affected by cancer, which explores:

  • what advance care planning is
  • the benefits, barriers, and their role in the process
  • how to start a conversation on advance care planning
  • the different ways a person can plan ahead
  • the legalities of advance care planning and how these differ across the UK.

Our Advance Care Planning video gives an overview of the Advance Care Planning process. Where appropriate, and if they find it useful, we’re asking professionals to watch this with the people they support to help introduce them to the process of advance care planning. Professionals can also direct people they support to our nation-specific information booklet Your Life and Your Choices: Plan Ahead.

For more detail on our Advance Care Planning resources, please email Anne McGee.

The words 'it wasn't good news I'm afraid' in the bottom left corner. In the middle a hand draws a woman on the phone in pencil.

Watch: Animation about advance care planning

Watch: Animation about advance care planning

Macmillan Specialist Care at Home

Macmillan Specialist Care at Home is a partnership approach to providing palliative care in the community. It’s based on the successful Midhurst Macmillan Specialist Palliative Care Service which began in 2006. People cared for at the Midhurst service have fewer A&E attendances, spend fewer days in hospital, and are more likely to die in their preferred place of care. In Midhurst, the model has had a real impact on patients and services. An independent evaluation concluded that this improved patient and carer experience could be replicated in other areas and could even decrease the cost of care. This is currently being tested by Macmillan and partner organisations in six Innovation Centres in England.


Macmillan wants to build on its existing bereavement information and support so that as many people as possible bereaved through cancer get the support and information they need. We have produced two booklets specifically for people who have been bereaved:

  • After someone dies: coping with bereavement- information, practical advice and emotional support for bereaved friends and family, and signposting to relevant services.
  • Preparing a child for loss - produced in collaboration with Winston’s Wish, it offers support around talking to children of all ages about death and dying, before and after they are bereaved.

Macmillan continues to identify new opportunities to develop bereavement support both before and after a death. We have recently formed a partnership with the National Bereavement Alliance with the view to extend our reach and improve the quality of support available for bereaved people.

End of life campaign

Too often, people’s wishes about care and support at the end of life aren’t being met. With the right support, 73% of people with cancer would prefer to die at home, yet only 30% are able to do so. This needs to change.

There should be better support to enable people to die in the place and manner of their choosing, in as little pain and with as much dignity as possible – and the government and NHS England must make that happen.

To improve end of life care in England, we’re urgently calling on the government to fully fund improvements recommended in an independent review of choice at the end of life, known as the Choice Review. We believe the Choice Review lays out recommendations that could truly transform end of life care, giving people the choices they deserve. Following the government’s response to the Choice Review, our CEO Lynda Thomas gave this statement on Macmillan’s position. 

Find out more about our campaign to improve end of life care.

Being at home made the situation easier for us to cope with. It was comforting to know Emile was in the place he wanted to be and surrounded by people he knew and loved.

Liz, campaign supporter