Please enter both an email address and a password.

Account login
Need to reset your password?  Enter the email address which you used to register on this site (or your membership/contact number) and we'll email you a link to reset it. You must complete the process within 2hrs of receiving the link.

We've sent you an email

An email has been sent to Simply follow the link provided in the email to reset your password. If you can't find the email please check your junk or spam folder and add no-reply@rcseng.ac.uk to your address book.

Appendices, Abbreviations, References and Further Reading

Please download the appendices below:

  • Appendix 1: Checklist framework for discussion with patients who may be nearning the end of life
  • Appendix 2: Illnesses and conditions where the burdens commonly outweigh the benefits of operating in the elderly
  • Appendix 3: "Thinking ahead": Gold Standards Framework Advance Care Planning Pro-forma
  • Appendix 4: Framework for M&M meeting discussion

List of abbreviations

ADRT

Advance Decision to Refuse Treatment

CPR

Cardiopulmonary resuscitation

DH

Department of Health

DNACPR

Do not attempt cardiopulmonary resuscitation

GMC

General Medical Council

GPs

General Practitioners

GSF

Gold Standards Framework

More information at: http://goldstandardsframework.org.uk

IMCA

Independent Mental Capacity Advocate

LPA

Lasting Power of Attorney

MDT

Multi-Disciplinary Team

M&M

Morbidity and Mortality

NHSE

National Health Service England

NICE

National Institute for Health and Clinical Excellence

PHE

Public Health England

RCP

Royal College of Physicians

RCS

Royal College of Surgeons

ReSPECT

Recommended Summary Plan for Emergency Care and Treatment

More information at: http://www.respectprocess.org.uk/

SPICTTM

Supportive and Palliative Care Indicators Tool. More information at: http://www.spict.org.uk/

VOICES

Views of Informal Carers – Evaluation of Services

More information at: www.ons.gov.uk

References

  1. National Palliative and End of Life Care Partnership. Ambitions for Palliative and End of Life Care: A National Framework for Local Actions. 2015. http://endoflifecareambitions.org.uk (cited August 2018).

2.       Leadership Alliance for the Care of the Dying People. One Chance to Get it Right: Improving People’s Experience of Care in the Last Few Days and Hours of Life. 2014. www.gov.uk/government/uploads/system/uploads/attachment_data/file/323188/One_chance_to_get_it_right.pdf (cited August 2018).

3.       Department of Health. End of Life Care Strategy: Promoting High Quality Care for All Adults at the End of Life. London: DH; 2008. www.gov.uk/government/publications/end-of-life-care-strategy-promoting-high-quality-care-for-adults-at-the-end-of-their-life (cited August 2018).

4.       Thomas K, Armstrong Wilson J, and GSF Team. The Gold Standards Framework Proactive Identification Guidance (PIG), 6th ed. Shrewsbury: National Gold Standards Framework Centre in End of Life Care; 2016. www.goldstandardsframework.org.uk/PIG (cited August 2018).

5.       General Medical Council. Good Medical Practice. London: GMC; 2013. www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/good-medical-practice (cited August 2018).

6.       SPICT Programme. Supportive and Palliative Care Indicators Tool (SPICTä). Edinburgh: University of Edinburgh; 2017. www.spict.org.uk (cited August 2018).

7.       General Medical Council. Treatment and Care Towards the End of Life: Good Practice in Decision Making. London: GMC; 2010. www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/treatment-and-care-towards-the-end-of-life (cited August 2018).

8.       Royal College of Surgeons of England. Good Surgical Practice. London: RCS; 2014. www.rcseng.ac.uk/standards-and-research/gsp (cited August 2018).

9.       Royal College of Surgeons of England. Consent: Supported Decision Making: A Guide to Good Practice. London: RCS; 2016. www.rcseng.ac.uk/standards-and-research/standards-and-guidance/good-practice-guides/consent (cited August 2018).

10.     Wright AA, Zhang B, Ray A et al. Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment. JAMA 2008; 300: 1665–1673.

11.     Wright AA, Keating NL, Balboni TA et al. Place of death: Correlations with quality of life of patients with predictor of bereaved caregivers’ mental health. J Clin Oncol 2010; 28: 4457–4464.

12.     Zhang B, Nilsson ME, Prigerson H. Factors important to patients’ quality-of-life at the End-of-life. Arch Intern Med 2012; 172: 1133–1142.

13.     Cooper Z, Courtwright A, Karlage A et al. Pitfalls in communication that lead to nonbeneficial emergency surgery in elderly patients with serious illness. Ann Surg 2014; 260(6): 949–957.

14.     Age UK. Advance Decisions, Advance Statements and Living Wills. Factsheet 72. London: Age UK; 2018. www.ageuk.org.uk/information-advice/money-legal/legal-issues/advance-decisions/# (cited August 2018).

15.     Sudore et al. 2017.[JM1]

16.     NHS National Cancer Action Team. The Characteristics of an Effective Multidisciplinary Team (MDT). London: NHS; 2010. www.ncin.org.uk/view?rid=136 (cited August 2018).

17.     General Medical Council. 0–18 Years: Guidance for All Doctors. London: GMC; 2007. www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/0-18-years (cited August 2018).

18.     National Institute for Health and Care Excellence. End of Life Care for Infants, Children and Young People with Life-Limiting Conditions: Planning and Management. NICE guideline NG61. London: NICE; 2016. www.nice.org.uk/guidance/ng61 (cited August 2018).

19.     Smith G, Pitcher D. Prevention of Cardiac Arrest and Decisions about CPR. London: Resuscitation Council (UK); 2015. www.resus.org.uk/resuscitation-guidelines/prevention-of-cardiac-arrest-and-decisions-about-cpr (cited August 2018).

20.     National Institute for Health and Care Excellence. Care of the Dying Adults in the Last Days of Life. NICE guideline NG31. London: NICE; 2015. www.nice.org.uk/guidance/ng31 (cited August 2018).

21.     National Institute for Health and Care Excellence. End of Life Care for Adults. Quality Standard QS13. London: NICE; 2011. www.nice.org.uk/guidance/qs13 (cited August 2018).

22.     ReSPECT. Recommended Summary Plan for Emergency Care and Treatment. www.respectprocess.org.uk (cited August 2018).

23.     National End of Life Care Intelligence Network. Palliative Care Co-ordination: Core Content. National Information Standard SCCI1580. London: Public Health England; 2015.

24.     Royal College of Physicians. National Care of the Dying Audit for Hospitals, England: National Report. London: RCP; 2014. www.rcplondon.ac.uk/projects/outputs/national-care-dying-audit-hospitals (cited August 2018).

25.     Office for National Statistics. National Survey of Bereaved People (VOICES): England 2015. Statistical Bulletin: Quality of Care Delivered in the Last 3 months of Life for Adults who Died in England. London: ONS; 2016. www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthcaresystem/bulletins/nationalsurveyofbereavedpeoplevoices/england2015 (cited August 2018).

26.     Point of Care Foundation. About Schwartz Rounds. https://www.pointofcarefoundation.org.uk/our-work/schwartz-rounds/about-schwartz-rounds (cited August 2018).

Further reading

Care Quality Commission. Inspection Framework: NHS Acute Hospitals and Independent Health: End of Life Care. London: CQC; 2018. www.cqc.org.uk/files/inspection-framework-acute-hospitals-end-of-life-care (cited August 2018).

Clarke D, Armstrong A, Allan A et al . Imminence of death among hospital inpatients: prevalent cohort study. Palliat Med 2014; 28(6): 474–479.

Downey L, Au DH, Curtis JR, Engelberg RA. Life-sustaining-treatment preferences: Matches and mismatches between patients’ preferences and clinicians’ perceptions. J Pain Symptom Manage 2013; 46: 9–19.

Fried TR, Bradley EH, Towle VR, Allore H. Understanding the treatment preferences of seriously ill patients. N Engl J Med 2002; 346: 1061–1066.

Fritz Z, Slowther A, Perkins GD. Resuscitation policy should focus on the patient, not the decision. BMJ 2017; 356: j813.

Gold Standards Framework Centre. Advance Care Planning. www.goldstandardsframework.org.uk/advance-care-planning (cited August 2018).

Henry C, Seymour J. Advance Care Planning: A Guide for Health and Social Care Staff. rev. ed. Leicester: NHS End of Life Care Programme; 2008.

Medical Protection Society. Consent – Children and Young People – England. London: MPS; 2014; last updated 2018. www.medicalprotection.org/uk/articles/eng-consent-children-and-young-people (cited August 2018).

NHS England. Actions for End of Life Care 2014–16. London: NHSE; 2014. www.england.nhs.uk/wp-content/uploads/2014/11/actions-eolc.pdf (cited August 2018).

Royal College of Physicians. Work and Wellbeing in the NHS: Why Staff Health Matters to Patient Care. London: RCP; 2015. www.rcplondon.ac.uk/guidelines-policy/work-and-wellbeing-nhs-why-staff-health-matters-patient-care (cited August 2018).

Royal College of Surgeons of England. Morbidity and Mortality Meetings: A Guide to Good Practice. London: RCS; 2015. www.rcseng.ac.uk/standards-and-research/standards-and-guidance/good-practice-guides/morbidity-and-mortality-meetings (cited August 2018).

Royal College of Surgeons of England. Surgical Leadership: A Guide to Good Practice. London: RCS; 2014. www.rcseng.ac.uk/library-and-publications/rcs-publications/docs/surgical-leadership-a-guide-to-best-practice (cited August 2018).

Share this page: