TY - JOUR T1 - Advance care planning: between tools and relational end-of-life care? JF - BMJ Supportive & Palliative Care JO - BMJ Support Palliat Care SP - 216 LP - 217 DO - 10.1136/bmjspcare-2015-000979 VL - 5 IS - 3 AU - Erica Borgstrom Y1 - 2015/09/01 UR - http://spcare.bmj.com/content/5/3/216.abstract N2 - The way in which end-of-life care is delivered in the UK has changed dramatically over the last few years. Owing to the changes in systems and care practice promoted in the End of Life Care Strategy1 more people have access to higher quality care, including advance care planning and symptom management. Drawing on the ‘best practice’ at the time, the Strategy recommended the use of several tools to facilitate identifying dying patients, communicating and planning future care, and coordinating otherwise disparate services. These changes have not gone unnoticed: in 2010, the UK was considered as the best place to die by the Economist Intelligence Unit,2 and recent UK data released as part of Dying Matters Awareness week suggest people are more comfortable talking about death and dying now than they were 10 years ago.3 Yet, end-of-life care has been described as ‘failing’, in a 2015 Parliamentary and Health Service Ombudsman's report, particularly in terms of discussing dying and documenting patient preferences.4A theme appears to be emerging from the history of attempts to scale up hospice-style care into acute and mainstream health services. It may be that focusing on the tools and documents of advance care planning risks undermining the discussions and relational care they are intended to support.This is evident in observations on how advance care planning documents and tools, such as the Preferred Priorities of Care, among others, have … ER -