How to record your wishes

You can record your wishes by making:

• an advance statement
• an advance decision to refuse treatment
• a lasting power of attorney

Advance statement

We use a document to record how you want to be cared for in the future or at the end of your life. This is called an advance statement.

In your advance statement, you can include anything that's important to you about your future health and care. It is different from an advance decision to refuse treatment, which is only used to refuse specific medical treatments.

An advance statement is not legally binding, but it can help us to follow your wishes. We use the document to make decisions that are right for you. This is important if you cannot make these decisions yourself.

The advance statement should be attached to your medical notes. This means that the people involved in your care can find the document easily. 

The planning process involves talking to the people involved in your care about what would improve your quality of life. This gives you the chance to think about and record:

• where you want to be cared for
• any worries or fears that you might have
• your values and identity
• your religious or spiritual beliefs
• how you like to spend your time

The charity Compassion in Dying has more information about making an advance statement.

Advance decision to refuse treatment

An advance decision to refuse treatment lets you write down specific treatments that you would not want to have in the future. It only becomes valid when you no longer have capacity. This means that the document is only used when you cannot make or communicate decisions for yourself.

The document is legally binding in England and Wales. Healthcare professionals must follow your wishes, provided that the advance decision to refuse treatment meets certain requirements. For example:

• you must be over 18 years old
• you must be able to understand what the advance decision to refuse treatment is and what it means for you
• you must sign the document (a witness must also sign it if you are refusing treatments to keep you alive)

Telling your healthcare team

It's your responsibility to tell your GP and hospital team if you make an advance decision to refuse treatment. They need to know about any documents that affect your care.

You can give your healthcare team a copy of your advance decision to refuse treatment. You can also tell a healthcare professional if you have made this document, but it's best to give them a copy.

If you have an advance statement, you should note in it that you've also made an advance decision to refuse treatment.

Lasting power of attorney

A lasting power of attorney (LPA) is a legally binding document. It lets you appoint a person, or people, that you trust to make decisions for you if you lose the ability to make decisions for yourself. They are called your attorney or attorneys.

Your attorney can only make decisions for you when you can no longer do this yourself. You must choose your attorney while you can still make your own decisions (have capacity).

A health and welfare lasting power of attorney gives your attorney the legal right to make decisions about:

• your medical treatment and care
• where you're cared for
• your daily routine (including how you dress and your diet)

You can find out more about a lasting power of attorney and make one online or download the paper forms at: gov.uk/power-of-attorney

The charity Compassion in Dying has more information about making a lasting power of attorney for health and welfare.

Telling your healthcare team

It's your responsibility to tell your GP and hospital team if you have a lasting power of attorney. They need to know about any documents that affect your care.

You can give your healthcare team a copy of your lasting power of attorney. You can also tell a healthcare professional if you have made this document, but it's best to give them a copy.

If you have an advance statement, you should note in it that you've also made a lasting power of attorney.

Universal Care Plan for London

If you live in London, you can ask a healthcare professional to include your wishes in the Universal Care Plan.

The Universal Care Plan is an NHS service. It allows every person who lives in London to record wishes about their care and what support they need. These wishes can then be shared digitally with healthcare professionals across London.

All health and care services who use the Universal Care Plan can see information saved on it. They include:

• the London Ambulance Service
• NHS 111
• out of hours GP services who might see you in an emergency

Your care plan can be kept updated to reflect any changes in your needs and wishes.

Find out more about the NHS Universal Care Plan.