- In response to the DHSS circular `Patients dying in hospital' (DA(84)17) the Bloomsbury District Management Team asked for an examination of the way that dying patients and their relatives are cared for in Bloomsbury hospitals. This paper arises out of that examination and also out of discussions with nurses, doctors and other people who care for dying patients and their relatives, and with relatives of patients who had recently died in hospital. The paper outlines agreed practice and focusses particularly on areas where people felt that current hospital provision was not always adequate. Although many of the good practices described here are already routine in most Bloomsbury hospitals, the introduction of others may involve changes in priorities or organisation. A few may require policy decisions. It is intended that this paper, and particularly the checklists, should help unit, hospital and ward staff to assess current practice and to make improvements where appropriate. The paper deals chronologically with care before death, at the time of death, and after death. Two key themes recur all the way through: first, the tremendous importance of good communication between staff, patients and relatives, and between all the different members of the team of staff caring for a patient; and second, the need for more training and support for doctors, nurses and other staff, to ensure that they are able to offer dying patients and their relatives the individual emotional and practical care they need.