Table 1.

Examples of situations that utilise estimated length of survival

Estimated length of survivalRelevance
Less than 1 yearThe approximate prognosis of patients to whom ‘end of life’ care policy documents and guidelines relate, for example National Institute for Health and Care Excellence and General Medical Council guidance. 3,4
One of the factors that helps to determine the suitability of patients for inclusion on community end of life care registers (eg the Gold Standards Framework).
Less than 6 monthsThe prognosis required for completion of a DS1500 form which allows patients access to certain welfare benefits (eg Personal Independence Payment, Universal Credit or Attendance Allowance) under the ‘special rules’.
Weeks to monthsClinicians completing the NHS fast-track tool for continuing care funding are advised that suitable patients should have a ‘rapidly deteriorating condition and may be entering a terminal phase’. Furthermore, applications should be ‘supported by a prognosis…[but] strict time limits that base eligibility on a specified expected length of life remaining should not be imposed’. 5 Nonetheless, in the authors’ experience applications for fast-track NHS continuing care funding are most likely to be approved if the prognosis is weeks to a few months.
Less than 2 weeksMost hospices offer inpatient admission either for symptom control or terminal care. Although no specific prognosis is mandated for terminal care admissions most hospices operate a ‘rule of thumb’ whereby terminal care admissions are targeted at those with a prognosis of less than 2 weeks. The average length of stay for admissions at inpatient hospices is 15 days. 6
Less than 72 hoursThe approximate prognosis of patients who would be deemed appropriate to be managed using an end of life care plan. Specific National Institute for Health and Care Excellence guidance is also available for patient care in the last days of life if there are no local care plans available. 7