Doctors are no better than patients at facing up to personal end-of-life care decisions

Family doctors would welcome more support in helping them talk to patients about death and dying. A survey by The King's Fund found that three out of four GPs agree that as professionals they have an integral role in end-of-life care and that they should be actively encouraging patients to plan for how they want to be cared for when they die. But at the same time, almost half (48 per cent) said they would value some support to help them deal with patients who are at the end of their lives.

There is widespread agreement that the NHS will only deliver better care if patients are able to talk openly to their doctors and to their families about the kind of care and treatment they want.

But this survey revealed that more than two-thirds of GPs (68 per cent) have not discussed the type of care they themselves would like at the end of their lives with their own doctor, family or friends – a similar result to those found in surveys of the general public.

The survey of 501 GPs found that:

  • only 5 per cent of GPs have written a living will or advance care plan making their wishes about end-of-life care clear;
  • less than half (42 per cent) have told relatives whether or not they want to be organ donors;
  • less than a quarter (23 per cent) have discussed their funeral plans.

The Fund's chief executive Niall Dickson said:

'Death and dying remain one of the last taboos. The fact that GPs themselves struggle with this issue shows how much further we have to go in tackling this topic. That means changing public attitudes and giving professionals more support in handling what can seem a daunting and sensitive area. The good news is that GPs tell us they would welcome that support.

'Too many people are not receiving the care they want and need at the end of their lives – part of that has to do with our collective failure to discuss these matters openly beforehand, when the pressure on everyone is much less.'

This research will be discussed today at a national summit on end-of-life care at Leeds Castle in Kent, which has been organised by The King's Fund. It is bringing together policy-makers, clinicians and carers to identify ways to implement the End of Life Care Strategy in England.

The King's Fund will publish a report and action plan from the national summit in December.

Notes to editors: 

  1. 76 per cent of GPs described their role in end-of-life care as ‘essential, it is an integral part of my job’ and 75 per cent agreed or strongly agreed that GPs should actively encourage patients to plan for their end-of-life care.
  2. 48 per cent of GPs said they would value access to ‘support for myself to help me to deal with patients who are at the end of their lives’; 29 per cent disagreed, 7 per cent disagreed strongly, 14 per cent didn’t know and 1 per cent preferred not to answer.
  3. Of the two-thirds of GPs (68 per cent) who haven’t discussed the type of care they would like when they die with either their own doctor, family or friends the two main reasons given were ‘death feels like a long way off’ (43 per cent) and ‘they have just never thought about it’ (42 per cent).
  4. The survey of 501 GPs was conducted by ComRes on behalf of The King’s Fund; fieldwork was conducted online between 4 and 9 November 2009. Full tables are available on the ComRes website
  5. A survey of public attitudes to death by the Dying Matters Coalition published on 13 November 2009 found that only 29 per cent of people had discussed their wishes around dying and just 4 per cent had written advance care plans.   For more about The King’s Fund work on end-of-life care please visit The King's Fund's Choice at the End of Life project
  6. For further information or interviews, please contact The King’s Fund press and public affairs office on 020 7307 2585, 020 7307 2632 or 020 7307 2603. An ISDN line is available for interviews on 020 7637 0185.
  7. The King’s Fund is a charity that seeks to understand how the health system in England can be improved. Using that insight, we help to shape policy, transform services and bring about behaviour change. Our work includes research, analysis, leadership development and service improvement. We also offer a wide range of resources to help everyone working in health to share knowledge, learning and ideas.