New GMC guidance on end-of-life care

GPs that have not made advance care plans for patients who are likely to die within 12 months must start to identify patients that this might be appropriate for, the GMC has outlined.

In its latest guidance, Treatment and care towards the end of life: good practice in decision making, the GMC said emotional distress and conflict between doctors, patients and relatives can usually be avoided through ‘early, sensitive discussion and planning about how best to manage the patient's care'.

It said doctors must make a record of discussions with patients about future care, as well as the decisions made. It also outlined that advance care plans will need to be reviewed and updated as the patient's situation or views change.

A spokeswoman said: ‘Doctors now need to identify patients for whom advanced care planning might be appropriate. They need to start thinking about who the patients are, and how to have a sensitive conversation with them about their future care.' 

The GMC highlighted that serious or persistent failure to follow the guidance will put doctors' registration at risk. ‘You must, therefore, be prepared to explain and justify your actions,' the guidance stated.

Dr Tony Calland, chairman of the BMA's medical ethics committee, said: ‘How best to care for individuals at the end of life is one of the most complex areas in medicine and it is essential that clear guidance is in place to assist doctors to act in the best interests of their patients.

‘We believe the GMC's new guidance is clear about the need to work with the patient or where appropriate their relatives or advocate to ensure that they are treated fairly, with dignity and without prejudice.'

Mayur Lakhani, a GP and chair of the National Council for Palliative Care and the Dying Matters Coalition, said: ‘The emphasis that the GMC's new guidance puts on the need for open and honest conversations between doctors, people approaching the end of life, and those close to them is very welcome.'

For more on the topic visit:

GP Curriculum Centre - 7 Care of Acutely Ill People

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