Guidance

The Special Rules for end of life: information for healthcare professionals

Updated 3 July 2025

Find out about getting benefits if you’re nearing end of life

Resources for healthcare professionals to promote the Special Rules for end of life

What the Special Rules are for

The Special Rules allow people nearing the end of life to:

• get faster, easier access to certain benefits
• get higher payments for certain benefits
• avoid a medical assessment

An adult or child is nearing the end of life when they are likely to have less than 12 months to live.

If a person is likely to have less than 12 months to live, they can make a fast-tracked claim to the following benefits (if they are eligible):

• Personal Independence Payment (PIP)
• Universal Credit (UC)
• Employment and Support Allowance (ESA)
• Disability Living Allowance (DLA) for children
• Attendance Allowance (AA)

Sending an SR1 form

You can be asked to provide medical evidence on an SR1 form to support a benefit claim made under the Special Rules.

You can return the SR1 form online, by email or by post.

The SR1 form has replaced the DS1500 form.

You should complete an SR1 form promptly if you have a patient who:

• has a progressive disease, and
• as a consequence of that disease, you would not be surprised if they were to live for less than 12 months

There are no negative consequences for the clinician or patient if a patient who claims under the Special Rules lives longer than expected.

If you are a GMC registered doctor, you can claim a fee for completing an SR1 form by completing a separate fee form. Email form.e-SR1@dwp.gov.uk to request a fee form or  follow the link given after you complete an SR1 form online.

Completing the SR1 form

It may be appropriate to complete an SR1 form:

• if you think the patient may meet the Special Rules for end of life eligibility criteria
• following a conversation about advance care planning
• as part of an assessment about current social and financial issues
• if requested by your patient or their representative

You will need to tell us the date your patient was first thought to meet the Special Rules criteria. This may be the date of diagnosis, the date the form is being completed or some alternative date in between. Providing this information will allow the DWP to ensure your patient receives payment from the correct date.

Your patient’s claim is likely to be helped if you include relevant information such as:

• no or poor response to treatment
• palliative care or palliative treatment in any form including palliative chemotherapy, immunotherapy or radiotherapy
• receiving symptom control and / or psychosocial support only
• no further treatment planned / available
• treatment is declined
• treatment ongoing but unlikely to alter prognosis

What we will do if we need to clarify any information

You may be contacted by a practitioner working for one of our clinical assessment providers if:

• information provided on an SR1 form needs to be clarified to help with a decision about the claim
• an individual has made a claim under the Special Rules but has not submitted an SR1 form and clinical information is required to support the claim

This will usually be a telephone call.

Understanding your patient’s eligibility for the Special Rules

The following indicators may suggest that a patient is eligible under the Special Rules:

• advanced, progressive illness
• rapid or gradual deterioration of incurable or terminal condition
• worsening symptoms despite optimal treatment or management
• (severe) degenerative condition
• metastatic disease
• inoperable cancer
• severe frailty
• death is imminent, death is inevitable
• high risk of sudden death with an underlying deteriorating condition

The Special Rules criteria do not only apply to patients with cancer. They also apply to other severe, life-limiting conditions, such as:

• end-stage respiratory disease (for example COPD, pulmonary fibrosis)
• end-stage heart disease
• end-stage dementia
• severe frailty regardless of age
• end-stage liver disease
• end-stage renal failure
• end-stage neurological disease (for example motor neurone disease, multiple sclerosis, Huntington’s disease)
• end-stage cystic fibrosis

This list is not exhaustive.

Patients may be eligible for the Special Rules when receiving ongoing or palliative treatment. In some circumstances, there may not be any treatment options available that would significantly alter prognosis.

Supporting patients

You should identify patients who you would not be surprised if they were to live for less than 12 months and use a holistic approach to consider the support that they may require.

If a patient asks for an SR1 form to be completed, do not assume that they understand the Special Rules criteria or that these criteria may apply to them. It could be an opportunity to explore their understanding of their condition, begin a discussion about advance care planning or document ‘what matters most’ to them. All claims made under the Special Rules are processed in a compassionate and appropriate manner.

You can find information about general or disease-specific indicators, advance care planning, palliative care initiatives and NICE guidelines on these websites:

• SPICT – Supportive and Palliative Care Indicators Tool
• The Gold Standards Framework Proactive Identification Guidance (PIG) Proactive Identification Guidance)
• Universal Principles for Advance Care Planning (ACP)
• The Daffodil Standards
• NHS England » Renewing our ambitions for palliative and end of life care
• NHS England » Palliative and end of life care
• Quality statement 1: Identification
• NICE Guideline for End of Life Care: Service Delivery
• What Matters to You Conversations

Who can make claims on behalf of patients?

For claims to UC and ESA, only an appointee or a person who has power of attorney can make a third-party claim on the patient’s behalf.

For claims to DLA, PIP and AA, any person representing the patient can make a third-party claim on their behalf, even if the patient is unaware that a claim is being made.