An introduction to advance care planning in practice

Advance care planning has been defined as a process of formal decision making that aims to help patients establish decisions about future care that take effect when they lose capacity.1 It recently gained increased importance in the United Kingdom, after being recommended by the end of life care strategy.2 The first national guidance for health and social care staff in the UK was produced in 2007 and revised in 2011.3 Before this, terms and concepts used in the UK had included “living wills” and “advance directives,” which have been replaced by terminology outlined in the national guidance and the Mental Capacity Act 2005.4

Advance care planning differs from general care planning in that it is usually used in the context of progressive illness and anticipated deterioration. This has implications for its acceptability to patients. It is a voluntary process and may result in a written record of a patient’s wishes, which can be referred to by carers and health professionals in the future. If a patient loses capacity, health and social care professionals should make use of information gleaned from the advance care planning process to guide them in decision making when needed.

The Royal College of Physicians and other national …