The Royal College of Physicians (RCP) has today launched a new policy position on end-of-life and palliative care, calling on government and health system leaders to transform how dying is recognised and supported across the NHS and social care.
The statement argues for a cultural shift – both within healthcare and wider society – towards more open conversations, earlier planning and better integrated care for people with progressive life-limiting conditions. It highlights the urgent need to move beyond a curative mindset to one that embraces personalised, anticipatory approaches to care.
‘Doctors of all career grades and specialties need the skills – and, vitally, the time – to recognise when a person is approaching the end of their life’, said Dr Hilary Williams, RCP clinical vice president. ‘Too often, that recognition happens only in the final days or weeks, and often in acute care settings. We can and must do better. Real change will only come when we value continuity of care, the involvement of experienced decision-makers, and we can give clinicians the time to have honest conversations with patients and families about what lies ahead.’
The RCP is calling on government to:
- launch a public awareness campaign about end-of-life and palliative care
- fund professional education and improvement to support better end-of-life care planning and delivery
- commission a national strategy, including a service framework, common dataset and aligned workforce planning.
‘As treatment options expand, knowing when to start or stop an intervention, when to investigate or when to focus on quality of life, is becoming more complex,’ added Dr Hilary Williams. ‘After all, anticipating the end of life is an act of clinical courage and kindness. These are hard-won skills rooted in expertise and experience – the system must learn to value them.’
The new position statement also highlights that 70% of people die from conditions with predictable trajectories. Yet many patients approaching the end of their life are cared for in emergency departments or hospital corridors – settings ill-suited to sensitive, dignified care.
‘Every doctor will care for people who are approaching the end of their life,’ said Dr Nick Murch, president of the Society for Acute Medicine. ‘Yet too often, this phase is seen as unexpected or a last-minute crisis. With the right support and planning, we can ensure more people are able to die in comfort, in a place of their choosing, and with dignity.’
The RCP’s new position statement recognises the vital role of generalist physicians in delivering end-of-life care, supported by specialist palliative services that are currently overstretched and unevenly available. It argues for better information sharing, aligned funding and multidisciplinary training across both health and social care.
Today’s position statement is supported by new research published in the July 2025 issue of Clinical Medicine (ClinMed), which highlights the complexity and opportunities of modern palliative care. Key messages include:
Earlier is better: patients referred to palliative care earlier in their illness have better quality of life, fewer hospital admissions and – sometimes – longer survival (Pask et al, Palliative care: what’s the evidence?)
Shared understanding is vital: confusion between ‘palliative’ and ‘supportive’ care can delay referrals and limit access to services that could greatly benefit patients (Taylor and Davies, Palliative care or supportive care?)
Communication matters: many doctors feel unprepared to lead conversations about dying. Yet advance care planning can improve patient relationships and experiences, and develop a collective shared understanding that preserves people’s identities and values for as long as possible (Robinson and Paes, Advance care planning)
‘We urgently need a national strategy to ensure that everyone has access to the high quality palliative care that they need, wherever they are, as early as necessary, around the clock,’ said Dr Suzanne Kite, president of the Association for Palliative Medicine. ‘Opportunities for patients, families and professionals to talk honestly about what matters in the final months and weeks of life must be embedded in care, and we need systems, training and public conversations that support this.’
The full position statement is available to download.
The July 2025 issue of Clinical Medicine is now online.
You might like…
- Read Talking about dying: how to begin honest conversations about what lies ahead, our 2021 report that offers advice and support for any doctor on holding conversations with patients soon after the diagnosis of a progressive or terminal condition, including frailty.
- Explore our clinically led quality improvement hub, Medical Care – driving change (MCDC) where the spotlight in May 2024 was on palliative care. Read blogs, watch videos and download resources to support your clinical practice.
- Read See it, say it, share it, our joint statement with Macmillan Cancer Support, the Society for Acute Medicine and the UK Acute Oncology Society on acute hospital admission as a key milestone in a patient treatment journey.
- Watch the Samuel Gee lecture 2025 available on our bespoke medical streaming service RCP Player: Less medicine and more care: the role of palliative care in the NHS, delivered by Professor Fliss Murtagh, professor of palliative care, Hull York Medical School.
- The Jeelani Drabu Palliative Care Programme, funded by the Drabu family, supports the development of palliative medicine as a specialty and palliative care as an integral element of healthcare provision in Pakistan. The RCP will host a 3-month online course (15 modules) in palliative medicine between November 2025 – January 2026, with the final examination taking place in February 2026. Free of charge, this course is exclusively for healthcare workers in the Jammu and Kashmir region. Applications will be open from 1 September – 31 October 2025.
- Read our acute care resource, End-of-life care in the acute care setting.
- Watch Palliative care: enhancing conversations and enhancing care, our MCDC webinar on improving the patient journey with proactive conversations and proactive palliative care.
- Watch our MCDC webinar Palliative care: avoiding and reducing acute hospital admissions and explore examples of initiatives which are reducing and avoiding acute admissions towards the end of life and in frailty.