Box 2.

Improving end of life care

• All professionals caring for people with an advanced progressive illness should adopt the WHO palliative care approach
• The information needs of patients and carers should be addressed through the use of relevant literature accompanied by individualised explanation
• Strategic planning across primary and secondary care, involving health and social care services working in partnership with specialist palliative care providers, is needed for people with advanced cardiac disease and other progressive illnesses
• Chronic disease management programmes should identify people who “reasonably might die”
• Professionals should receive training in communication skills so that they can discuss diagnosis, prognosis, treatment options, end of life care, and psychological and spiritual issues more effectively with patients and their carers
• Specialist palliative care advice in hospitals and in the community should be available for patients with advanced non-malignant disease
• Palliative care specialists should be trained in the management of advanced non-malignant illnesses