In recent years, increasing emphasis has been placed on the identification of patients with supportive and palliative care needs. Prognostic models have been introduced in the UK, Holland and Catalonia to aid clinical decision-making in patients with advanced conditions at risk of dying.1–3 This journal has recently published a review of such tools and a survey of their usage throughout Europe.4 However, as the collective drive to identify patients intensifies, it is reasonable for health professionals to question the value of such an investment of time and effort. Due to the variable trajectory of chronic disease, many patients identified as being in the last year of life survive beyond this period, often by …