Advance care planning describes the process of discussion between individuals and their care providers about the individual’s preferences and priorities for their future care. ACP is particularly important for people with a life-limiting condition as they are likely to deteriorate in the future and may then lack capacity or be unable to communicate their wishes to others.

Practitioners from South Gloucestershire, Bristol and North Somerset have developed a set of documentation for use by patients. These can also be a useful aid to practitioners to help structure what can be difficult conversations, and to ensure that the patient’s wishes are recorded and communicated to other relevant parties.

Guidance for practitioners on how to use the documentation, and advice on how to approach advance care planning is provided in the Bristol, North Somerset and South Gloucestershire advance care planning for adults affected by a life limiting condition document

The documents available to support advance care planning are:

• Preferred priorities for care
• Allow a natural death (Do not attempt resuscitation)
• Advance decision to refuse treatment
• Putting your affairs in order
• Funeral planning
  Coping with a death - a guide to the days following a bereavement
• Other useful planning documentation

Preferred priorities for care (PPC): This form is useful as a method of recording a person’s ‘statement of wishes and preferences’. It is a patient held record which gives individuals a chance to describe their values, priorities regarding future care, and preferred place of death.

•  Preferred Priorities for Care document
•  Guidance for completion of preferred priorities for care document

Allow a natural death (Do not attempt resuscitation): This document is particularly appropriate in the community setting, and where a patient is being transported by ambulance. It remains with the patient, and has to be authorised by a medical practitioner and incorporates reviews thereby maintaining validity. It is accompanied by a pathway so if the patient does die in the ambulance vehicle the onward journey for the patient is clear and creates minimal upset for the family. The key requirement of the Ambulance Trusts is that this form is on yellow paper or in a yellow file thereby standing out from other medical records and paperwork.

• Allow a natural death form

Advance decision to refuse treatment (ADRT): This document allows patients to record where they have strong feelings about specific treatments they have decided they do not want in particular circumstances in the future.

• Advance decision to refuse treatment form and guidance

Putting your affairs in order: This document is a checklist to help patients to think through specific issues, which they may wish to sort out in advance of their death.

• Putting your affairs in order – a checklist

Funeral planning: This is document which helps patients to think through the specific elements when planning a funeral.

• Funeral planning form

Other useful planning documentation

1.  Framework for Do Not Attempt Cardio-Pulmonary Resuscitation (CPR) Decisions

2. Ordering Unified Do Not Attempt Cardio-Pulmonary Resuscitation (DNACPR) forms

3. Decisions relating to cardiopulmonary resuscitations
   Review of the key ethical and legal issues that should inform all CPR decisions
    
4. Do not attempt resuscitation decision making framework
   Review of the decision making process with regard to resuscitation
    
5. Guide to independent mental capacity advocacy services
   Guide to the role of the independent mental capacity advocacy service, when a patient lacks capacity
    
6. Guide to lasting power of attorney
   A guide for those wishing to make a personnel welfare lasting power of attorney
    
7. Executive summary of advance decision to refuse treatment
   Overview of the legislation and the use of advance decision to refuse treatment
    
8. End of life care planning for children with life-limiting conditions
   Overview of end of life care planning for children, with links to important documentation.