A new report published today by the Royal College of Physicians explores why doctors and other healthcare professionals find it hard to talk to patients about dying and why “timely, honest discussions about their future that patients want are not happening”.

“Talking about Dying: How to begin conversations about what lies ahead” is based on conversations with doctors at all levels, patients, carers and medical organisations. It identifies culture, confidence and practicalities as the primary barriers to talking about death and dying. Also included in the report is a section on “myths and mythbusters” around death, dying and end of life care designed for healthcare professionals. 

According to the report: “For people to live as well as possible despite long-term and terminal illnesses, integrated and wholesystem care is required. We all need to be equipped to offer patients honest conversations about what they can expect in the future, to give them choices and control over the remainder of their lives. This is not just about high-quality palliative care in the last weeks or days, but about holding conversations much earlier after diagnosis of a progressive or terminal condition, including frailty.”

The report’s key recommendations include:

- improving communication with patients about how much information they would like and recognising that having conversations about the future is a process and not a “tick-box” exercise

- proactively initiating conversations about advance care planning and preferences with patients with chronic conditions, more than one serious medical problem or terminal illness

- being aware of the language used around patients and their loved ones

Dallas Pounds, CEO of Royal Trinity Hospice said: “We know that there are many benefits to talking openly about death and dying for all of us, but for patients with terminal illness and their loved ones these conversations should begin at the earliest stage possible. It’s important that everyone has time and the support they need to consider and discuss advance care planning and their preferences.

“We encourage early referral to Trinity so patients and families can benefit from the breadth of support we offer, but honest conversations about death and dying with healthcare professionals can and should begin before this. Those conversations can only happen effectively if professionals have the confidence and skill to initiate and participate in them.

“At Trinity, we’re proud to share our expertise in skilled, compassionate end of life and palliative care through support and training to colleagues working throughout the community we serve. We welcome today’s report calling for greater attention and emphasis on conversations about death and dying”.

Dr Samantha Lund, Medical Director at Trinity said: “It is reassuring to see the recommendations in today’s report. Trinity is involved with so much teaching – last year we trained over 560 people including medical students, and junior doctors who rotate through Trinity on placement including foundation year 1 doctors, GP trainees and core medical trainees. 

“Learning to talk about death and dying with patients and their loved ones is an incredibly important part of what they do here at Trinity and we welcome the report’s emphasis on improving these skills.”

View Trinity’s current training and education opportunities here