Dying in an acute hospital setting: the challenges and solutions

Int J Clin Pract. 2009 Mar;63(3):508-15. doi: 10.1111/j.1742-1241.2008.01991.x.


More than half of all UK deaths occur in hospital, yet evidence suggests that the quality of inpatient end of life care is suboptimal at best. Over half of all NHS complaints pertain to problems with care in the dying phase, particularly with regard to poor communication. This is a hugely topical area following the recent publication of the Department of Health's End of Life Care Strategy. With reference to current literature, we seek to investigate the challenges associated with providing 'a good death' in hospital and construct a framework of strategies for improvement; including communication skills training, use of integrated care pathways, advance planning, educational initiatives and the role of the palliative care team.

Publication types

  • Review

MeSH terms

  • Attitude of Health Personnel*
  • Attitude to Death*
  • Communication
  • Hospitalization
  • Humans
  • Medical Staff, Hospital / education*
  • Medical Staff, Hospital / standards
  • Patient Care Team / standards
  • Physician-Patient Relations
  • Prognosis
  • Quality of Health Care / standards*
  • Right to Die*
  • Terminal Care / methods
  • Terminal Care / standards*
  • United Kingdom