Advance or anticipatory care planning and coronavirus
Advance or anticipatory care planning ensures that someone's wishes are known when it comes to treatment and the future. Coronavirus means more people might be thinking about creating an advance care plan.
Advance care planning (ACP) is a voluntary discussion between an individual, those close to them and their care provider(s). It enables people to plan for the future, ensuring their wishes are known when it comes to treatment and further care. It includes things like the sort of medical interventions they may or may not want if they become very ill and helps the person get the care that's right for them.
This process is referred to as advance care planning in England, Wales, and Northern Ireland, and anticipatory care planning in Scotland.
Who is advance care planning for?
Advance care planning is something that anyone might find helpful and reassuring, but can be particularly important to people who have a progressive illness or who are approaching end of life.
Here are some resources to help primary care professionals find relevant guidance around how coronavirus affects their patients.
The coronavirus crisis means more people might be thinking about creating an advance care plan. This is because people who are vulnerable to coronavirus due to a pre-existing condition can deteriorate quickly and become unable to communicate their wishes. We understand conversations with your patients about things like this can be difficult. We have more information to help with difficult conversations and coronavirus.
Advance care planning key messages
Advance care planning should:
- be voluntary
- be sensitive and timely, and at the level of understanding of the individual, loved ones and carers
- be proactive, rather than reactive
- involve shared decision making
- involve the right people – family, multi-disciplinary professionals, if appropriate
- be person-centred and include discussions about what matters to the individual
- be documented and shared with family and health and social care professionals (with permission)
- be regularly reviewed and updated in writing or if a person’s condition, personal circumstances or preferences change.
We also have information about advance care planning for people living with cancer. You may find this helpful to share with your patients.
There are lots of resources available about advance care planning. To help you support your patients during this time, we've listed some coronavirus ACP specific resources, as well as some more general ACP guidance.
Coronavirus specific ACP resources
The General Medical Council has information on what advance care planning looks like during the coronavirus crisis. This includes answers to commonly asked questions about practising during an emergency.
Here are some coronavirus and advance care planning resources that are specific to different regions:
- NHS England has an advance care planning guidance and template document called My COVID-19 Advance Care Plan.
- The Royal College of Physicians of Edinburgh hosted a podcast about ACP during the coronavirus pandemic. It features Dr Paul Baughan & Dr Deans Buchanan.
- Scottish Care and Health Improvement Scotland have collaborated to develop some coronavirus specific ACP templates and guidance.
- Health Improvement Scotland’s ihub has an Essential Anticipatory Care Planning Toolkit. This has been developed to support health and social care staff with ACP conversations and includes information relating to coronavirus.
- The Public Health Agency in Northern Ireland are directing people to the GOV.UK website for guidance about coronavirus for health and social care settings.
- NHS Wales has provided a collection of Advance and Future Planning resources and templates for use during the coronavirus crisis.
General ACP resources
Here are some advance care planning resources that are specific to different regions:
England and Wales
- Advance Care Plan is a website that draws on the expertise of NHS Wales, the National Council of Palliative Care, Hospice UK as well as other organisations from across the country to help people start thinking about their Advance Care Plan. There are lots of resources on their website including videos and templates.
- Health Education England has a comprehensive e-ELCA module in Advance Care Planning for all staff delivering end of life care. It covers the principles of advance care planning, spiritual and cultural considerations, conducting conversations and illness trajectories.
- The Royal College of General Practitioners Wales has an ACP online training resource.
- NHS inform Scotland has a website for patients about ACP that explains the importance of planning ahead and how to make an ACP.
- The Health Improvement Scotland (HIS) website has a section on ACP guidance. This includes templates and videos.
- Palliative Care in Partnership have developed a regional palliative care website with a helpful overview of Advance Care Planning in Northern Ireland
- The All-Ireland Institute of Hospice and Palliative Care have a palliative hub on their website. It includes booklets and checklists to help people plan ahead.
There are different things to think about when creating an Advance care plan. We have information for your patients about different ways they can plan ahead. You might find it helpful to share this with them.
- Document their wishes for their care.
- Create a power of attorney (Scotland) or a lasting power of attorney (England or Wales).
- Create an
- advance directive (Scotland)
- advance decision to refuse treatment (England or Wales)
- advance decision to treatment (Northern Ireland) - 'Your Life and Your Choices: Plan Ahead Northern Ireland' - page 43.
- Write a will.
- Record their wishes for organ and tissue donation.
- Plan their funeral.
- The British Geriatrics Society have information about managing the COVID-19 pandemic in care homes for older people.
- The National Institute for Health and Care Excellence (NICE) have an advance care planning guide for registered managers of care homes and home care services.
People with learning difficulties
- Beyond Words is a charity that provides books and training to support people who find pictures easier to understand than words. They have produced a booklet called Jack plans ahead for coronavirus.