The short answer
- Ask the GP and the hospice firstHospice at home teams and the Marie Curie nursing service both support people at home, and in many areas that includes overnight. It is free. What is available depends on where you live.
- Free nights are rarely every nightA charity night sit is usually a handful of nights rather than a run of them. Families most often use both: the free nights when they come, paid nights in between.
- Ask about fast-track fundingWhere someone has a rapidly changing condition, the NHS fast-track route can fund care without the usual assessment. The aim is a decision within 48 hours.
- A paid night carer is bookable today£130 to £160 a night with our fee included, one night at a time, the same carer each time.
This page describes how care is arranged, not medical advice. The GP, the district nurse and the hospice team are the people to ask about symptoms and medicines.
Who is there at night
The six people who can be part of the night
Families are often surprised by how many services are involved and how little of it is joined up. Below is each of them, what they do after dark, whether they stay, what they cost and who to ring to arrange them.
District nurses
NHS, through the GP
Pain relief and the syringe driver, dressings, catheters, pressure care and the equipment that makes being at home possible. They visit, sometimes at night if there is an urgent need, and then they move on to the next house.
Visits, does not stay
How to ask. Ask the GP for a district nurse referral, and ask for the out-of-hours district nursing number.
Hospice at home
Local hospice charity
Nurses and trained carers from the local hospice who support people at home. In many areas the service includes night sits, though usually a limited number of nights rather than every night.
Some nights, in many areas
How to ask. Ask the GP, the district nurse or the hospice directly. You do not always need a referral to ring and ask what they offer.
The Marie Curie nursing service
Marie Curie, a national charity
A Marie Curie nurse or senior carer who stays overnight so the family can sleep. Marie Curie says the service is free and is arranged through health professionals, and how much of it is available depends on the area.
Overnight, where available
How to ask. Ask the GP or the district nurse to refer. Marie Curie also runs a free support line for families.
The GP and out of hours
NHS
The number to ring at 3am when something changes or pain is not controlled. Out-of-hours doctors can visit and can prescribe. Ask the GP whether anticipatory medicines are in the house already, so nothing waits for a pharmacy.
Comes out when called
How to ask. Write the out-of-hours number on the fridge before you need it.
Family and friends
You
The people who know them. Family do the things nobody else can, and they are also the people who run out first, because caring all day and listening all night is not something anyone does for long.
Every night, until they cannot
How to ask. Share the nights out rather than letting one person take them all, and let a paid carer take the rest.
A paid night carer
A carer you choose
This is the one part of the night you can decide on rather than wait for. It is the same carer on every night you book, awake or sleeping nearby, doing comfort care, mouth care, repositioning, drinks and medication that is due, so that the family can go to bed.
Every night you book
How to ask. Search night carers near you, message two or three, and speak to them the same day.
What the NHS and the hospices can offer varies a lot by area, and none of it can be promised from a web page. Ask the GP or the local hospice what is available where you are before you plan around it.
What is free
The night help you do not pay for
Four services can be involved without a bill. What they cover varies by area, and knowing what to ask for makes most of the difference.
| What it covers at night | What it does not cover | How to ask | |
|---|---|---|---|
| District nurses | Pain relief and syringe drivers, catheters, dressings, pressure care and the equipment that makes home possible. Many areas have a night team for urgent visits. | They visit and then move on to the next house, so nobody stays the night. | Through the GP. Ask for the out-of-hours number as well as the daytime one. |
| Hospice at home | Nurses and trained carers from the local hospice. In many areas the service includes night sits so the family can sleep. | Usually a limited number of nights, and not every hospice offers overnight cover. | Ring the hospice yourself, or ask the GP or district nurse to refer. |
| The Marie Curie nursing service | A nurse or senior carer who stays overnight at home. Marie Curie says the service is free and is arranged through health professionals. | Availability depends on the area and how many nurses are free that week. | Ask the GP or the district nurse to make the referral. |
| Macmillan | Specialist nurses for symptoms, advice and benefits, plus a free support line for families. | Macmillan nurses are not generally an overnight sitting service. | Through the GP, the hospital team or the Macmillan support line. |
District nurses
- What it covers at night
- Pain relief and syringe drivers, catheters, dressings, pressure care and the equipment that makes home possible. Many areas have a night team for urgent visits.
- What it does not cover
- They visit and then move on to the next house, so nobody stays the night.
- How to ask
- Through the GP. Ask for the out-of-hours number as well as the daytime one.
Hospice at home
- What it covers at night
- Nurses and trained carers from the local hospice. In many areas the service includes night sits so the family can sleep.
- What it does not cover
- Usually a limited number of nights, and not every hospice offers overnight cover.
- How to ask
- Ring the hospice yourself, or ask the GP or district nurse to refer.
The Marie Curie nursing service
- What it covers at night
- A nurse or senior carer who stays overnight at home. Marie Curie says the service is free and is arranged through health professionals.
- What it does not cover
- Availability depends on the area and how many nurses are free that week.
- How to ask
- Ask the GP or the district nurse to make the referral.
Macmillan
- What it covers at night
- Specialist nurses for symptoms, advice and benefits, plus a free support line for families.
- What it does not cover
- Macmillan nurses are not generally an overnight sitting service.
- How to ask
- Through the GP, the hospital team or the Macmillan support line.
What each service offers is decided locally, so treat all of this as what to ask for rather than what you will get. The GP and the hospice will tell you in one phone call what is available where you live.
There are two things families tell us afterwards. The first is that they did not know the hospice would take a phone call from them directly, and waited weeks for a referral that they could have started themselves. The second is that free night sits, where they exist, are usually offered for a few nights rather than a run of them, and often at short notice, which makes them hard to plan a fortnight around. Neither of those is a reason to skip the free help. They are a reason to ask for it early, and to have a paid arrangement you can turn on around it.
The wider picture of who does what at home, including the daytime, is in our guide to care at home at this stage, and private palliative carers explains what an experienced carer is trained to do alongside the nurses.
What paying adds
What a paid night carer adds to the free help
A paid carer does not replace the district nurse or the hospice. They cover the part of the night that is yours to decide, on the nights nobody else is able to.
Every night, not some nights
The same face
Comfort care through the night
A pair of eyes on the clock
The family gets to sleep
Short notice period
The carers families book for this are experienced ones. On PrimeCarers you can see who has worked with a hospice team before, read their reviews, and speak to them on the phone before anyone comes to the house. That conversation matters more here than for any other kind of booking, and it is worth doing it with two or three people rather than one. Before a profile goes live we check the carer's identity and right to work, see an enhanced DBS certificate, and interview them online. Carers are insured while they work.
A night, hour by hour
What a carer does between ten and seven
Families ask what someone does all night. It is a long list of small things, done at the right time, and most of it is about comfort rather than treatment.
- 9pm
Handover from the family
How the day went, what medicines are due and when, what has been hard, and what the family want to be woken for. That last question is worth answering out loud.
- 10pm
Settling for the night
Mouth care, a wash if it is wanted, pillows and positioning, clean sheets, the light and the radio the way they like them, and the family sent to bed.
- 12am
Repositioning
Turning every couple of hours protects skin and eases breathing. Done gently and without switching the lights on, most people barely wake.
- 2am
Mouth care and sips
A dry mouth is one of the most common causes of discomfort at this stage, and one of the easiest to relieve. Small sponges, lip balm, a teaspoon of water.
- 3am
Medicines that are due
Regular medicines given on time. Where the district nurses have left anticipatory medicines in the house, the carer knows they are there and rings the out-of-hours team rather than waiting.
- 4am
The quiet hours
A chair by the bed, a low lamp, a hand held. There is nothing to report, and for many families this is the whole reason they booked.
- 7am
Handover to the family
How the night went, what was given and when, what the district nurse should know, and whether the carer is back tonight.
If the days are becoming as hard as the nights, look at live-in care rather than adding more nights. One carer in the house around the clock is usually calmer for everyone than a rota of visits, and for a couple of weeks it often costs less than nights plus daytime visits. If the strain is falling on one family carer, respite care and overnight care so the family carer can sleep are the two pages to read next.
Fast-track funding
NHS continuing healthcare when time is short
There is a route through the NHS funding system built for exactly this situation, and a lot of families never hear about it.
48 hours
Where a fast-track application is made, the aim is for the NHS to make a decision and get care in place within about two days rather than the weeks a standard assessment takes.
NHS continuing healthcare, fast track pathway. Ask the GP, the hospital team, the district nurse or the hospice; any of them can complete the form.
NHS continuing healthcare is a package of care funded entirely by the NHS for people whose needs are mainly health needs rather than social ones. The standard route involves a checklist and then a full assessment, and it takes weeks. The fast-track route exists for people whose condition is changing rapidly, and it skips the assessment: a doctor or nurse completes a short form and the NHS is expected to put care in place quickly.
There are a few things worth knowing before you ask. It has to be started by a health professional, not by the family, so the question to ask the GP, the district nurse or the hospice nurse is a direct one: is a fast-track application appropriate here. Where it is agreed, the funding can cover care at home, including nights, and it is not means tested. Where it is not agreed, or while you are waiting, families usually pay for the first nights themselves and stop paying if funding comes through. Our full guide to NHS continuing healthcare covers eligibility, the checklist and what to do if the answer is no, and help paying for care has the other routes including council funding and benefits.
What a week costs
What paid nights cost, and how a week adds up
Nights are priced per night rather than per hour, and there is no minimum block on PrimeCarers, so a week can be two nights or seven.
- 3 sleeping nights£390The usual first booking, on the nights the family cannot cover.
- 3 waking nights£450Where there is a syringe driver, regular turning or restlessness after dark.
- 7 waking nights£1,050Every night covered, usually shared between two carers.
- Live-in, one week£1,120Days and nights from one carer, who sleeps at night. Add waking nights if nobody should be asleep.
- Agency waking nights, 7£1,680The top of the agency range for the same seven nights.
PrimeCarers rates, August 2026, our fee included. Sleeping nights £130 to £145, waking nights £150 to £160.
Seven waking nights a week needs more than one carer, because nobody can work seven nights in a row and stay sharp. Two carers alternating is the usual arrangement, and it is worth setting up from the start rather than when the first one is exhausted. Seven nights a week explains how a full rota is built, and the night-time carers cost guide breaks the prices down further. Every figure on the site sits together on the cost of care page.
Arranging it this week
How to get nights covered in the next few days
There are five steps. The first three are free, and most families have a carer at the house within 48 hours of starting.
- 1
Ring the GP surgery
TodayAsk for a district nurse referral if there is not one already, ask for the out-of-hours numbers, and ask directly whether a fast-track NHS continuing healthcare application is appropriate. Ask about anticipatory medicines being in the house so nothing waits for a pharmacy at 2am. - 2
Ring the local hospice
Today, freeAsk what their hospice at home service covers, whether they can offer night sits, and whether a Marie Curie referral is possible in your area. You can usually ring them yourself without waiting for a referral. - 3
Write down what the nights need
10 minutesMedicines and times, how often they need turning, whether they are settled or restless after dark, who the family want woken for what, and where a carer can sit or sleep. This becomes the brief you send to carers, and the district nurse can help you write it. - 4
Message two or three night carers
FreeSearch night carers near you, look for experience alongside a hospice or district nursing team, and send the same brief to two or three. Speak to them on the phone the same day. Most families choose on that call. - 5
Book the first nights, and keep asking
This weekBook the nights you are sure about, one at a time. Keep the hospice and the funding conversations going in parallel, because free nights and fast-track funding can both arrive after you have already started, and paid nights stop with a message.
Questions
Questions families ask
It is care given at home overnight for someone in the last weeks or days of their life. It covers comfort rather than treatment: mouth care, repositioning to protect skin and ease breathing, clean sheets, regular medicines given on time, calling the district nurse or out-of-hours doctor when something changes, and being present so the person is not alone and the family can sleep. It can be given by a hospice at home team, a Marie Curie nurse or a paid night carer, and the district nurses visit alongside all of them.
Marie Curie says its nursing service is free, and in many areas it includes a nurse or senior carer who stays overnight at home so the family can sleep. It is arranged through health professionals rather than booked directly, so ask the GP or the district nurse to refer. How much is available depends on the area and on how many nurses are free that week, so it is worth asking early and having something else in place around it.
In many areas, yes. Hospice at home services are run by local hospice charities and are free, and a number of them offer night sits. It is usually a limited number of nights rather than every night. You can often ring the hospice directly rather than waiting for a referral, and they will tell you in one call what they can offer where you live.
On PrimeCarers, £130 to £145 for a sleeping night and £150 to £160 for a waking night, with our fee included. Most families booking nights at this stage book waking nights. An agency charges up to £240 for the same night and usually wants a minimum block. Nights are booked one at a time here, with 48 hours’ notice to stop.
It can, through NHS continuing healthcare. Where someone has a rapidly changing condition, a doctor or nurse can complete a fast-track application, which skips the usual assessment; the aim is a decision and a package within about 48 hours. Where it is agreed, the NHS funds the care, including nights, and it is not means tested. It has to be started by a health professional, so ask the GP, the district nurse or the hospice nurse directly whether it applies.
No. A night nurse is a registered nurse and can do clinical tasks such as setting up a syringe driver. A night carer is not a nurse and works alongside the district nursing team, doing comfort care, personal care, repositioning, mouth care and regular medicines where that has been agreed, and calling the nurses when something needs them. Most nights at home are covered by carers with the nurses visiting.
Often within 24 to 48 hours if you message two or three carers rather than one. The free services can take longer to arrange, so many families start paid nights straight away and stop or reduce them if hospice nights or NHS funding come through afterwards. Notice to stop is 48 hours, so very little is wasted by starting.
Some families want to and manage it, particularly where several people can share. What does not work is one person doing every night for weeks while also doing the days. The arrangement that holds up is the family taking the times they most want to be there and a paid carer taking the rest, so that nobody is running on two hours of sleep at the point when they most want to be present.