Professor Murtagh stressed the importance of having earlier conversations with patients and their families about possible deterioration and approaching death, to ascertain their wishes. Without such conversations, patients may continue to have high-cost treatment they may not benefit from.43 NHS England agreed, and acknowledged that it had more to do to ensure all patients in the last year of life have advanced care plans to support the right care being delivered in the patients’ preferred settings.44 Growing financial crisis in the adult hospice sector