Identifying end of life
Revise how GPs identify people who may be approaching the end of life, record decisions, review needs and coordinate care with community teams.
MRCGP AKT end of life revision
End-of-life questions test calm GP judgement: identifying deterioration, planning care, managing symptoms, communicating with families, and making lawful decisions around capacity and CPR.
Quick answer
For AKT end-of-life revision, prioritise palliative care planning, anticipatory medicines, DNACPR, advance decisions, capacity, symptom control, syringe-driver principles, last-days care, carers and care after death.
What to revise first
Advance care planning
Know personalised care planning, treatment escalation plans, preferred place of care, advance statements and advance decisions to refuse treatment.
DNACPR and capacity
Focus on decision-specific capacity, best interests, consultation, documentation, communication with families and the difference between DNACPR and overall treatment ceilings.
Common symptoms
Cover pain, breathlessness, nausea, agitation, secretions, constipation, cachexia, fatigue and when urgent specialist palliative advice is needed.
Anticipatory medicines
Understand why medicines are prescribed in advance, what symptoms they cover, syringe-driver principles and how renal impairment or frailty affects prescribing.
Care after death
Revise verification, certification awareness, bereavement support, safeguarding, coronial referral signals and communication with relatives and carers.
Red flags to recognise quickly
- Uncontrolled pain, breathlessness, agitation, vomiting, bleeding or distress that needs urgent palliative or acute-care input
- Possible spinal cord compression, hypercalcaemia, superior vena cava obstruction or other oncological emergency
- New confusion, reduced consciousness, sepsis features, dehydration, medication toxicity or reversible cause of deterioration
- Capacity uncertainty, conflict about treatment decisions, unclear best-interests process or missing documentation
- Carer breakdown, unsafe home situation, safeguarding concern, medication access failure or no overnight support
- Unexpected death, trauma, neglect concern, recent operation or circumstance that may need coronial advice
Why this topic catches candidates out
The difficult AKT questions are rarely about memorising a drug list. They test whether you can balance comfort, safety, capacity, patient wishes, family distress, carer support and when to call for specialist help.
AKT end of life FAQ
Is end-of-life care high yield for the MRCGP AKT?
Yes. People at the end of life is a named RCGP curriculum topic. AKT questions commonly test palliative care planning, anticipatory medicines, capacity, DNACPR, last-days care, carers and communication.
What should I revise first for AKT end-of-life care?
Prioritise identifying patients approaching end of life, personalised care planning, DNACPR, advance decisions, capacity, symptom control, anticipatory medicines, syringe-driver principles and care after death.
What is the AKT trap with DNACPR?
The trap is treating DNACPR as a decision to stop all active treatment. DNACPR only relates to CPR. Other treatment decisions still need clinical judgement, patient wishes, capacity assessment and best-interests reasoning.
How do anticipatory medicines come up in AKT questions?
They usually appear as a patient deteriorating at home or in a care home. The question tests whether you recognise common end-of-life symptoms, prescribe safely and know when to seek specialist palliative support.
Official sources
This is revision guidance, not official RCGP advice. Check current RCGP, NICE, GMC, local palliative care pathways, local prescribing guidance and BNF guidance for clinical decisions. Last reviewed June 2026.
October sitting
Oct 26
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days
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