Guidance for clinicians on talking about dying

NEW guidance has been published to help doctors talk to patients who are coming to the end of their life.

The Royal College of Physicians’ (RCP) Talking about dying 2021: How to begin honest conversations about what lies ahead provides advice and support for doctors on holding conversations with patients soon after the diagnosis of a progressive or terminal condition, including frailty.

The guidance – an update to the College’s original 2018 report – has been published to coincide with Dying Matters Awareness Week 2021. It includes a set of mythbusters on palliative care and cardiopulmonary resuscitation (CPR), a number of recommendations for physicians, and a full copy of the 2018 report.

Launching the new document, the RCP said the advice is "more relevant than ever, with many clinicians having seen more deaths during the pandemic than they ever did before". It also acknowledges the experiences of many doctors who were redeployed as part of the Covid-19 response and who have had to provide "more palliative care than they had training for or were used to in their specialties".

The College notes that, while, nearly half of all deaths in England occur in hospital, almost a third of patients at the end of their life (29 per cent) report not having an individualised care plan.

RCP president Dr Andrew Goddard said clinicians should remember that discussions about death and dying can have a positive impact on patients and their families.

He said: "Advance care planning and early introduction of palliative care can improve a patient’s quality of life and mood, reduce aggressive treatments towards the end of life, reduce emergency hospital admissions and in certain groups it can even extend a patient’s life expectancy.

"I hope that this guidance equips clinicians with the skills and confidence to take these conversations forward."