One of the great taboos for the British is talking openly about death and dying - that’s the opinion of Professor Mayur Lakhani chair of Dying Matters, the coalition raising awareness of dying death and bereavement.

In October 2010, NHS local met him and a group of GPs who were sharing their experiences of dealing with end of life issues.

"This is about good clinical care and it’s about managing people appropriately and avoiding treatments that are inappropriate or futile," says Prof Mayur.

Sophia Christie, chief executive of NHS Birmingham East and North and the national QIPP lead for End of Life believes talking about  issues around dying and bereavement is more taboo than talking about sex. And it’s a human rights issue.

She says people could take more control of their experience at the end of their lives if they knew more about what options they have.

If things were handled differently, the NHS could spend a lot less money and patients would have a better experience.

"The reality is that at the moment not only are we giving people quite a bad time but it’s costing a fortune," she says.

Perhaps surprisingly, many of the GPs present voiced difficulties in dealing with the issues around dying.

Finding the best way to start a conversation with dying patients and their families can be a big challenge.

Patients will drop into conversation cues that hard pressed GPs choose not to pick up.  Others see it as a risk to bring the topic up in a consultation if it has not been prompted by the patient.

But Dying Matters want GPs to talk to patients nearing the end of their lives a lot more.

Eve Richardson, chief executive of Dying Matters, says: "The NHS has been so concerned about saving lives that it forgets that actually a good quality of death is a part of a good life."

Note (13 March 2012): Sophia Christie is no longer chief executive of NHS Birmingham East and North. She is chief executive at UKPrime Ltd.

Due for review August 2013