This document provides guidance for healthcare professionals on end of life care. It outlines steps to take when a patient is irreversibly deteriorating and further interventions will not help, including contacting palliative care teams and making decisions based on multidisciplinary discussions. It recommends regular communication with the patient and family, addressing physical, psychological and spiritual needs, and ensuring the patient's preferences are followed, including preferences around place of death and DNACPR orders. It also provides guidance on symptom management, care after death, and supporting the family.