Intended for healthcare professionals

Views And Reviews Acute Perspective

David Oliver: Should advance care planning enter the mainstream?

BMJ 2018; 361 doi: (Published 15 May 2018) Cite this as: BMJ 2018;361:k2123
  1. David Oliver, consultant in geriatrics and acute general medicine
  1. Berkshire
  1. davidoliver372{at}

Contact with the acute care system, especially repeated contact, is often a sign that life expectancy is limited. Around a third of adult patients in an NHS acute bed are in the last year of their lives, although many won’t know it, and nor can doctors necessarily predict it. About 40% of over 65s will die within 12 months of leaving hospital.[1] [2] Those with severe frailty are four times more likely to die within 12 months.

You might think, when someone is becoming very frail or has a life limiting condition diagnosed, that this would open the way for specific decisions about end-of-life care and its limits. Yet such advance care …

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