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Feature End of Life Care

Training on death and dying: handle with care

BMJ 2011; 342 doi: (Published 23 May 2011) Cite this as: BMJ 2011;342:d3110
  1. Margaret McCartney, general practitioner and freelance journalist
  1. 1 Glasgow, UK
  1. margaret{at}

Are the millions of pounds being poured into training doctors and other healthcare workers to communicate better over death and dying money well spent? asks Margaret McCartney

There is no doubt that death and dying are among the more difficult areas of medical practice. But is the training doctors get at medical school and in specialist training programmes sufficient?

A recent report from a special NHS project suggests not.1 Over the past year the NHS National End of Life Care Programme has funded 12 pilots to identify gaps in training and develop a new communications skills programme.

The final report of the pilot scheme suggests linking these end of life training courses to revalidation of general practitioners, “embedding” the project within the Care Quality Commission, and “supporting GP consortia to commission end of life care training.”1 Bold aims indeed. These courses are not designed just for doctors and nurses working in oncology but for all health and social work professionals.

Back in 2008 the Department of Health published a national strategy for end of life.2 The background to the strategy explained that most deaths (58%) occur in NHS hospitals, with around 18% occurring at home, 17% in care homes, 4% in hospices, and 3% elsewhere. Against these figures it noted that: “There are distressing reports of people not being treated with dignity and respect and many people do not die where they would choose to.” It felt that there was …

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