What are the key elements to include when delivering a diagnosis of a terminal illness to a patient?

Key elements when delivering a diagnosis of a terminal illness to a patient include:

• Assess the patient’s communication needs and preferences: Determine if the patient wishes to have someone important present, their current understanding of their condition, cognitive status, and any specific communication needs including cultural, religious, social, or spiritual preferences.
• Choose the appropriate healthcare professional: The person delivering the diagnosis should be competent, confident, and have a good rapport with the patient.
• Provide clear, honest, and accurate information: Explain the prognosis including any uncertainties without giving false optimism, unless the patient prefers not to be informed.
• Allow space for emotional response and questions: Give the patient and those important to them opportunities to discuss fears, anxieties, and ask questions about their care.
• Discuss and explore advance care preferences: Check if the patient has any advance statements, advance decisions to refuse treatment, or legal lasting power of attorney for health and welfare.
• Ensure shared decision-making: Establish the patient’s desired level of involvement in decisions, respect their goals and wishes, and involve those important to them as appropriate.
• Document and communicate the prognosis and care plan: Record discussions and decisions in the patient’s care record and share with the multiprofessional team and the patient’s support network.
• Provide ongoing support and opportunities for further discussion: Offer contact details for the care team and ensure the patient can revisit discussions as their condition or preferences change.

These elements ensure that the delivery of a terminal diagnosis is patient-centred, compassionate, and supports informed decision-making in line with NICE guidelines on care of dying adults ¹.