GPs urged to play greater role in end of life care

By Gareth Iacobucci

The General Medical Council has urged GPs to take on a more prominent role in end of life care by helping to set up advance care plans for terminally ill patients at an earlier stage in their illness.

The advice came as the GMC launched its updated guidance for Treatment and care towards the end of life, originally produced in 2002, and re-launched following a consultation with patients and doctors.

The guidance stresses the need for improved communications between doctors, other healthcare professionals, patients and their families to help empower patients to make decisions about their care.

The GMC recommended that GPs play ‘a pivotal role' in setting up advanced care plans at least a year before patients are expected to die, in order to give them more control over their end of life care.

It said these plans could be adjusted accordingly as patients wishes may change during the course of their illness.

Jane O'Brien, GMC head of standards and ethics, said GPs had ‘an enormously important role to play'.

‘Very often, they have had a longer relationship, and more understanding of the long-term needs,' she said.

GMC chief executive Niall Dickson said the revamped guidance reflected the trend of more patients choosing to die at home or in other community settings such as care homes rather than in hospital.

He said: ‘Evidence suggests the number of people wishing to die at home or in care homes far outnumbers the number who actually do. Advance care planning will make it more likely that they can have their wish carried out.'

The GMC said the guidance does not cover any discussions around assisted suicide, as it only advises on things within the law.

Dr Tony Calland, chair of the BMA's Medical Ethics Committee, said: 'The BMA has been involved with the development of this guidance and we support it. How best to care for individuals at the end of life is one of the most complex areas in medicine and it is essential that clear guidance is in place to assist doctors to act in the best interests of their patients.

'We believe the GMC's new guidance is clear about the need to work with the patient or where appropriate their relatives or advocate to ensure that they are treated fairly, with dignity and without prejudice.'