Letter to the editor

The ‘preferred place of care’ (PPC)1 patient assessment tool, recently renamed ‘preferred priorities for care’, is one of three interventions promoted within the National Health Service (NHS) End of Life Care Initiative. PPC offers patients, their carers and healthcare professionals the opportunity to consider, discuss, express and record priorities for care at the end of life. Department of Health guidance highlights how ‘available evidence suggests that whilst over 50% of all patients wish to spend their final days at home, less than 20% in practice are actually able to do so’.2 Nationally, the proportion of home deaths for patients with cancer is falling, from 27% in 1994 to 22% in 2003.3 Choice over care is a fundamental tenet of government policy. A retrospective quantitative and spatial analysis of the first 100 PPC assessments identified patients’ and carers’ preferences for care and place of death at the end of life, and highlights issues for the development of PPC.