Table 1

The Buckinghamshire declaration: the care of the dying and the NHS. Brief summary of selected points (www.nuffieldtrust.org.uk)

  1. An authoritative document, based on best practice, should be produced and made nationally available for use by health professionals wherever they practice

  2. The quality of services to the dying needs to be audited

  3. Attitudes, both public and professional, need to change

  4. Central government should take a lead in setting national standards for provision and training in care of the dying

  5. In each hospital, and healthcare setting, there should be clear lines of responsibility for ensuring that basic equipment and drugs needed to care for dying patients are available in adequate quantities, every day of the year

  6. Attitudes among staff need to change, replacing the spirit of paternalism/maternalism to one of partnership with patients

  7. The nursing profession must continue to encourage its members to prove that they are safe to practise and safe to teach others, both nurses and care staff

  8. Further beacon sites of excellence should be identified, and used to disseminate good practice to staff throughout the NHS

  9. Risk assessment of the bereaved can enable special help to be made available to those who most need it; it should be offered more widely