Health service guidance states that doctors should discuss with relations whether or not their loved one is placed on the scheme which allows medical staff to withdraw fluid and drugs in a patient’s final days. In many cases this is not happening, an audit has found. As many as 2,500 families were not told that their loved ones had been put on the so-called Liverpool Care Pathway, the study disclosed.

In one hospital trust, doctors had conversations with fewer than half of families about the care of their loved one. In a quarter of hospital trusts, discussions were not held with one in three families.

Overall, doctors discussed plans with relations in 94 per cent of cases, which is an improvement since the last audit but still means thousands of families were not informed. Under the guidance, patients who are close to death can be placed on the Liverpool Care Pathway, so called because it was developed at the Royal Liverpool Hospital in the 1990s. It aims to ensure they die without being subjected to unnecessary interference by staff.