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Advance Care Planning in End of Life Care$

Keri Thomas and Ben Lobo

Print publication date: 2010

Print ISBN-13: 9780199561636

Published to Oxford Scholarship Online: November 2011

DOI: 10.1093/acprof:oso/9780199561636.001.0001

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(p.283) Appendix 1 Useful websites and resources

(p.283) Appendix 1 Useful websites and resources

Advance Care Planning in End of Life Care
Oxford University Press

Mental Capacity Act 2005: Information booklets

Current information is available from:



Mental Capacity Act: Code of Practice (2007):


Royal College of Physicians: National Guidelines Advance Care Planning: Concise guidance to good practice, number 12. An excellent guidance document produced by the Royal College of Physicians on the benefits and uses of ACP in England


Advance Care Planning: A Guide for Health and Social Care Staff


Guidance on key issues and challenges of incorporating ACP into routine patient care, key principles and definitions of ACP and related terms, and how ACP links to the Mental Capacity Act.

Advance Decisions to Refuse Treatment: A Guide for Health and Social Care Staff


A guide to help health and social care professionals understand and implement the new law relating to advance decisions to refuse treatment, as contained in the Mental Capacity Act 2005.

Advance Decisions to Refuse Treatment

This approved website contains valuable resources for both patients and professionals on Advance Decisions and many related end of life care issues: www.adrtnhs.co.uk

ADRT decisions check list: http://www.adrtnhs.co.uk/pdf/Advance_Decisions_Checklist.pdf

My Advance Decisions to Refuse Treatment Form

ADRT example proforma: http://www.adrtnhs.co.uk/pdf/EoLC_appendix1.pdf

People and professionals might use this example or develop it to meet their own individual or local needs. There are other examples but care is required to ensure that they comply with the legal requirements.

Decisions relating to cardiopulmonary resuscitation:

A joint statement from the British Medical Association, the Resuscitation Council (UK), and the Royal College of Nursing www.resus.org.uk/pages/dnar.pdf

Clinical Decisions Algorithm

The process for making clinical decisions in serious medical conditions in patients over 18 years. In Regnard C, Hockley J, Dean M. (2008) A guide to Symptom Relief in Palliative Care. Radcliffe Publishing, 6th ed.

(p.284) Differences between general care planning and decisions made in advance (PDF)


A guide to show differences between ACP and ADRT published March 2010

Planning for your future care: a guide (PDF)


A simple and easy to understand guide for patients making Advance Care Plans for their future. It may prove relevant to family members and informal carers.

Gold Standards Framework


General guidance and information on the use of Advance Care Planning as part of the Gold Standards Framework programmes in end of life care, primary care, care homes, acute hospitals, and other settings. GSF helps to identify which patients may be in the final year or so of life, using the Prognostic Indicator Guidance Paper (Appendix 2) and thereby to trigger the ACP discussion. Examples of an ACP tool the ‘Thinking Ahead’ paper that is frequently used in care homes is included.


The National Council for Palliative Care


  • The Mental Capacity Act in Practice

  • Good Decision Making: The Mental Capacity Act and End of Life Care

Liverpool Care Pathway for the Final days


Preferred Priorities of Care


Some examples from other countries (others included in the relevant chapters):

Australian: Respecting0 Patient Choices

An extensive ACP programme run in many settings in Australia, based at Austin Hospital, Melbourne www.respectingpatientchoices.org.au


Literature Review on advance directives. Wilkinson AM, Wenger N, Shugarman LR. (2007). Available at: http://aspe.hhs.gov/daltcp/reports/2007/advdirlr.pdf

‘Respecting Choices Advance Care Planning Facilitators Manual,’ Gundersen Lutheran Programs for Improving End-of-Life Care, Gundersen Lutheran Medical Foundation, 2000. http://www.gundluth.org/eolprograms

(p.285) Canada

Advance Care Planning: ‘Let's Talk’


Living Lessons® is an information and resource program developed through a partnership between the GlaxoSmithKline Foundation and the Canadian Hospice Palliative Care Association. More information may be found at http://www.living-lessons.org.