This is one of a suite of case studies designed to increase awareness of schemes to move healthcare closer to home. The Midhurst Macmillan Palliative Care Service provides acute-level care at home to patients nearing the end of their lives. Important features are personal case management to co-ordinate all aspects of care, a seven-day service and cross-skilled staff. Patients are assessed for psychosocial, medical and social needs at the same time. Single assessments help reduce stress and accelerate care planning. Counsellors work with patients and families before and after bereavement.