For the first time, the General Medical Council has given doctors in the UK guidance on advanced care planning for patients nearing the end of life, including how to manage advanced requests and the refusals of treatment. It emphasises to doctors the importance of listening to patients and recording an advanced care plan to ensure that everyone involved in treating the patient can understand and follows their wishes.
The new guidance, “treatment and care towards the end of life: good practice in decision making”, has been developed to help clinicians with the shared decision making that can result in improved end of life treatment and provide better care to patients. The guidance stresses the vital importance of good communications between clinicians, patients and their families as well as between members of the whole healthcare team.
Jonathan Hope, a member of the patient and carer steering group and the CEO sponsor group of the modernisation initiative end of life care programme in Lambeth and Southwalk and speaker at the GMC’s End of Life Care Conference said “I have had 25 years of kidney failure and in that journey I have faced death, seen fellow patients die, observed the difference between a good and a bad death and cared for the dying. Much of the care has been exceptional, however, I believe it would be easier for us each to receive the end of life care we would like if, as doctors and patients, we were more open about dying. I welcome this guidance, which I believe will help all patients and their families have a voice in how they want to die”.
Niall Dickson, the GMC’s Chief Executive added “in the UK we have led the world in the care of patients at the end of life but we also know there is more that can be done. Every day at the front line of care doctors are having hard conversations with patients and their families and helping them to make incredibly emotional and difficult decisions. We hope this guidance will support them in providing the best quality of care and support”.
This guidance comes into force on 1 July 2010. It will be the requirement by which individual doctors are judged. It is another significant step in mainstream conservative and end of life care which is such an important aspect of kidney care, not only for all doctors but for the whole multiprofessional team.