Last year, a group within the BMA embarked on a project to examine what its recently published report called ‘end-of-life care issues and options’. Most of its report1 is devoted to identifying ‘what changes are needed to ensure that our members are able to provide high quality end-of-life care for all of their patients’. Unsurprisingly, its recommendations are sensible, uncontroversial and necessary. No one disputes that ‘national governments need to make end-of-life care a top priority’ or that ‘education and training in end-of-life issues is crucial for large numbers of doctors for whom end-of-life care is not the sole component of their work’, that ‘mental health services for people at the end of life should be more readily available’ or that ‘governments should consider how to make hospice provision available on an equitable basis’. However, it merely joins a pile of equally worthy and comprehensive pieces of work, repeating what is needed.

The year ‘2015’ was a year of valiant attempts to move end-of-life care forward. First, one would hope that a coalition of the willing would provide traction. Well, the hard work that followed the Neuberger Review in 20132 found culmination, under the leadership of Professor Bee Wee, with some actions along the way3 in a comprehensive group of patient, health, social and national charitable organisations produced the fruit of its labour, which offered up a clear and visionary framework of Ambitions for Palliative and End of Life Care,4 but they are merely ambitions.

Second, it is reasonable to expect that a Government commissioned report, making …