Advance care planning: between tools and relational end-of-life care?

The way in which end-of-life care is delivered in the UK has changed dramatically over the last few years. Owing to the changes in systems and care practice promoted in the End of Life Care Strategy more people have access to higher quality care, including advance care planning and symptom management. Drawing on the ‘best practice’ at the time, the Strategy recommended the use of several tools to facilitate identifying dying patients, communicating and planning future care, and coordinating otherwise disparate services. These changes have not gone unnoticed: in 2010, the UK was considered as the best place to die by the Economist Intelligence Unit, and recent UK data released as part of Dying Matters Awareness week suggest people are more comfortable talking about death and dying now than they were 10 years ago. Yet, end-of-life care has been described as ‘failing’, in a 2015 Parliamentary and Health Service Ombudsman's report, particularly in terms of discussing dying and documenting patient preferences