Complete guide to NHS end of life care in the UK — palliative care delivery, advance care planning, DNACPR decisions, hospice coordination, bereavement support, and end of life care software.
500,000 people die each year in the UK. 75% would benefit from end of life care planning, but only 30% receive it. Advance care planning reduces unwanted hospital admissions by 50% and improves quality of death.
End of Life Care Priorities
| Priority | Description | Target |
|---|---|---|
| Recognise dying | Identify people in last 12 months of life | All patients identified |
| Communicate honestly | Sensitive, honest conversations about prognosis | All patients offered |
| Support carers and family | Practical and emotional support for families | All families offered |
| Coordinate care | Seamless care across settings | Care plan shared across providers |
| Control symptoms | Effective symptom management | Pain controlled in 95%+ cases |
| Place of choice | Support preferred place of death | 60%+ die in preferred place |
Palliative Care Services
- Hospital palliative care team: Specialist doctors and nurses for inpatients
- Hospice care: Inpatient and day hospice services (200+ hospices in UK)
- Community palliative care: Macmillan nurses and hospice-at-home teams
- Syringe driver service: Continuous subcutaneous medication for symptom control
- Bereavement support: Counselling and support groups for families
- Spiritual care: Chaplaincy and spiritual support
- Children's palliative care: Specialist services for children and young people
Advance Care Planning Tools
- Advance statement: General preferences for care (not legally binding)
- Advance decision (ADRT): Refusal of specific treatment (legally binding)
- Preferred Priorities for Care (PPC): Document recording care preferences
- Emergency Health Care Plan (EHCP): Clinical plan for emergencies
- ReSPECT: Recommended Summary Plan for Emergency Care and Treatment
- NHS Spine sharing: ACP shared with all NHS providers via NHS Spine
Frequently Asked Questions
- What is NHS end of life care?
- NHS end of life care supports people in the last 12 months of life to live as well as possible until they die. It includes palliative care, advance care planning, symptom management, psychological support, and bereavement care. 500,000 people die each year in the UK; 75% would benefit from end of life care planning.
- What is a DNACPR decision?
- DNACPR (Do Not Attempt Cardiopulmonary Resuscitation) is a medical decision that CPR will not be attempted if the patient has a cardiac arrest. It's made by a senior clinician based on clinical assessment, in consultation with the patient and family. DNACPR must be reviewed regularly and communicated to all care providers.
- What is advance care planning in the NHS?
- Advance care planning (ACP) is a voluntary process where patients discuss and record their preferences for future care. It includes: treatment preferences, place of death preference, key people to involve, and values. ACP is stored in the patient's record and shared via NHS Spine. It reduces unwanted hospital admissions by 50%.