Palliative Medicine Interview Questions & Answers

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About this NHS interview question bank

To prepare for a palliative medicine NHS interview, expect questions on symptom control and anticipatory prescribing, syringe drivers, recognising dying, conversations about prognosis, advance care planning and ReSPECT, and how you work across hospital, hospice and community teams. Panels also probe how you handle families in conflict, requests for hastened death within UK law, safeguarding, verification of death and the medical examiner system, and how you look after yourself and your colleagues. Build short spoken answers around real patients you have cared for, and read the GMC end of life guidance and the NICE guidance on care of dying adults before you go in.

This bank contains 40 original practice questions with first-person model answers for doctors applying for palliative medicine posts in the NHS and in hospices, pitched mainly at Clinical Fellow and Specialty Doctor level, with a selection aimed at doctors stepping towards consultant or senior specialty roles. It covers hospital palliative care teams, inpatient hospice units and community working, and every answer is built around a realistic, non-identifying scenario. Each question explains what the panel is really looking for, the points you must hit, the mistakes to avoid and the guidance worth reading, so you can practise answers that sound like you rather than a textbook.

 

What this question bank covers

• Motivation for palliative medicine
• Hospice and NHS partnership working
• Recognising dying
• Anticipatory prescribing
• Syringe drivers
• Pain, breathlessness, nausea and agitation
• Palliative emergencies
• Communicating prognosis
• Advance care planning and ReSPECT
• Mental Capacity Act and best interests
• Clinically assisted hydration and nutrition
• Requests for hastened death and UK law
• Families in conflict
• Spiritual care and bereavement
• Safeguarding adults and children
• Controlled drugs safety
• Equity of access to palliative care
• Confidentiality after death
• Verification of death and the medical examiner system
• Incidents, PSIRF and Duty of Candour
• Teaching, audit and quality improvement
• Staff support and resilience

 

40 NHS interview questions with full model answers. The first 8 are free to read below. Unlock the remaining 32 for £2.99 (12 months' access).

These are original practice questions written to reflect how NHS interviews are run. They are not leaked or official questions, and Healthcare Interview Prep is independent of the NHS.

 

 

Free NHS interview questions and model answers

 

 

Question 1: Why do you want to work in palliative medicine?

Motivation question  ·  Motivation

 

What the interview panel is assessing

The panel wants a genuine, personal reason rooted in real patients, not a general wish to be kind. They are listening for an understanding that palliative medicine is skilled, active medicine as well as communication, and for some realism about the emotional weight of the work.

 

Model answer

I can actually point to the night it started. I was a junior doctor on a medical ward, covering an elderly man with metastatic lung cancer who was clearly in his last days. He was restless and frightened, his daughter was standing in the corridor in tears, and nobody had written up anything for the symptoms we could all see coming. I rang the palliative care registrar on call, and she talked me through what to prescribe, how to explain to the daughter what was happening, and what to hand over. Within an hour he was settled, and his daughter sat holding his hand instead of pacing. He died peacefully the next afternoon.

What struck me was that this was proper medicine. It needed a good assessment, careful pharmacology and clear thinking, and it changed the experience of dying for him and his family completely. I'd spent years learning to fix things, and here was a whole specialty built around making things better when you can't fix them.

Since then I've sought out every chance to do more. I've worked alongside the hospital palliative care team, joined family meetings, and I've learned that the conversations are as technical as the prescribing. You have to listen properly, give honest information in amounts people can take, and respect what matters to them, which isn't always what matters to us.

I won't pretend it's easy. Some days are heavy, and I've learned I need to talk things through and look after myself to keep doing it well. But I come home from a day in palliative care feeling I've been useful in a way that really counts, and that's why I want this to be my working life.

 

Why this answer works

It opens with a concrete clinical moment rather than a cliche, which makes it believable. It shows the candidate understands palliative medicine as skilled clinical work as well as communication, and it acknowledges the emotional demands while showing insight into self-care.

 

Key points to include

• A specific patient or moment that shaped your choice
• Palliative medicine as active, skilled medicine, not just kindness
• Communication as a clinical skill
• Focus on what matters to the patient and family
• Realism about the emotional load and how you manage it

 

Common mistakes to avoid

• Saying you simply want to help people at the end of life
• Describing the specialty as giving up or doing less
• Only talking about communication and ignoring symptom control
• Sounding unprepared for the emotional side of the work

 

NHS values and standards

Compassion; Improving lives; Respect and dignity; GMC Good Medical Practice: knowledge, skills and development

 

Further reading

• GMC Good Medical Practice
• GMC Treatment and care towards the end of life: good practice in decision making
• Ambitions for Palliative and End of Life Care: a national framework for local action

 

 

Question 2: How do you recognise that a patient is dying, and what do you do once you have?

Clinical Scenario question  ·  Clinical Scenario

 

What the interview panel is assessing

The panel is testing whether you can recognise the last days of life safely, without missing reversible causes, and whether you know what good care looks like once dying is recognised. They want to hear about uncertainty, shared decision making with the team and family, and a practical plan.

 

Model answer

It's rarely one sign. It's a pattern over hours or days, and I try to look at the whole picture rather than one result. Typically I'd see someone with a progressive illness becoming more drowsy, sleeping most of the day, taking very little by mouth, struggling to swallow tablets, with changes in breathing or colour, and a general sense of decline that the nurses and family often notice before the numbers do.

The first thing I do is ask whether anything reversible is driving it, because I don't want to label someone as dying when they've got opioid toxicity, hypercalcaemia, an infection or a drug interaction we could treat. If treating it fits with the person's wishes and is likely to help, we treat it. I also accept there's real uncertainty, so I'd talk with the MDT and my senior and say clearly that we think the person may be dying in the coming days, while staying alert to any improvement.

Once we agree that, I'd want to talk with the patient if they're able and with the people important to them. I'd explain honestly what we're seeing, what we expect, and what we'll do to keep them comfortable. I'd ask what matters to them, including spiritual or cultural wishes and where they'd like to be.

Then the practical plan. I'd review all medications and stop anything that isn't helping comfort, prescribe anticipatory medicines for pain, breathlessness, nausea, agitation and respiratory secretions, and think about whether a syringe driver is needed. I'd make sure the ReSPECT form or resuscitation decision is clear, review routine observations and blood tests, and have a considered conversation about hydration. Mouth care and skin care matter enormously at this stage.

Finally I'd document it clearly, communicate it at handover and to the GP if they're at home, and review the person at least daily, because plans need to change as things change.

 

Why this answer works

The answer balances recognition of dying with a check for reversible causes and honest acknowledgement of uncertainty. It describes the practical priorities that national guidance emphasises: communication, individualised care, anticipatory medicines, hydration and regular review.

 

Key points to include

• Dying is recognised from a pattern, often first noticed by nurses and family
• Exclude reversible causes such as opioid toxicity, hypercalcaemia or infection
• Acknowledge uncertainty and agree the decision with the MDT and seniors
• Sensitive communication with patient and family about what is happening and what matters
• Rationalise medication, prescribe anticipatory medicines, consider hydration and resuscitation decisions
• Clear documentation, handover and at least daily review

 

Common mistakes to avoid

• Labelling someone as dying without considering reversible causes
• Presenting the decision as certain and permanent
• Forgetting to involve the family or ask what matters to the patient
• Describing a checklist without individualising care

 

NHS values and standards

Compassion; Respect and dignity; Commitment to quality of care; GMC Good Medical Practice

 

Further reading

• NICE guideline: Care of dying adults in the last days of life
• One Chance to Get it Right: Leadership Alliance for the Care of Dying People
• GMC Treatment and care towards the end of life
• Your local last days of life care plan or individualised care guidance

 

 

Question 3: A patient with advanced cancer asks you directly, 'How long have I got?' How would you respond?

Communication question  ·  Communication

 

What the interview panel is assessing

The panel wants to see whether you can handle prognostic uncertainty honestly and kindly, without false precision or evasion. They are listening for exploration of what the patient wants to know, checking understanding, and responding to emotion.

 

Model answer

The first thing I'd do is not rush. That question often comes when you're halfway out of the door, so I'd sit down, make sure we had some privacy, and ask if they'd like anyone with them.

I'd want to understand what's behind the question before I answer it. So I might say something like, 'That's a really important question, and I'll be honest with you. Can I ask what's made you think about it today?' Sometimes the person wants a timeframe because they're planning a wedding or a trip home. Sometimes they're frightened and really asking whether they'll be in pain. Sometimes they already sense the answer and want it confirmed. Knowing that changes how I answer.

I'd also check how much detail they want. Some people want numbers, others want the broad picture. When I do answer, I try to be honest about uncertainty without hiding behind it. I'd talk in ranges, such as days to weeks, weeks to months, or months, and explain what we're basing that on, like how much they're sleeping, eating and getting about, and how things have changed recently. I'd also be clear that individuals vary and that it could be shorter or longer.

Then I'd stop and let it land. Silence is fine. I'd acknowledge whatever emotion comes, whether that's tears, anger or relief, and ask what they're thinking. Often the most useful next step is to ask what matters most to them in the time ahead, because that opens up planning around where they want to be, who they want to see and what they'd want if they became more unwell.

Before finishing I'd check what they've understood, offer to talk to family with their permission, document the conversation clearly so colleagues don't contradict it, and make sure they know who to contact if more questions come up overnight.

 

Why this answer works

This answer models a recognised structure for difficult conversations: setting, exploring perception and wishes, giving honest information in ranges, responding to emotion and planning next steps. It avoids false precision while not using uncertainty as a reason to avoid the question.

 

Key points to include

• Make time and space, offer to have someone present
• Explore why they are asking and how much they want to know
• Give honest information in time ranges, explaining the basis and the uncertainty
• Allow silence and respond to emotion
• Move to what matters most and future planning
• Document and share the conversation with the team

 

Common mistakes to avoid

• Giving a precise figure such as 'three months'
• Deflecting with 'nobody can say' and leaving it there
• Talking without pausing or checking understanding
• Not documenting, so the next doctor gives a different message

 

NHS values and standards

Compassion; Respect and dignity; Working together for patients; GMC Good Medical Practice: communication and partnership

 

Further reading

• GMC Decision making and consent
• GMC Treatment and care towards the end of life
• NICE guideline: Care of dying adults in the last days of life
• Gold Standards Framework guidance on prognostic indicators

 

 

Question 4: Talk us through how you would prescribe anticipatory medicines for a patient approaching the end of life.

Clinical Scenario question  ·  Clinical Scenario

 

What the interview panel is assessing

The panel is checking safe, individualised prescribing for the five common symptoms in the last days of life. They want to hear that you consider renal and hepatic function, current opioid use, local formularies and communication with community teams, rather than reciting a fixed list.

 

Model answer

I think of anticipatory prescribing as making sure that if a symptom appears at three in the morning, someone can treat it quickly without waiting for a doctor. So the aim is a small set of as-needed injectable medicines for pain, breathlessness, nausea and vomiting, agitation or distress, and respiratory secretions, all individualised to that person.

I always start with the patient in front of me. Are they already on an opioid, and if so which one and what dose? If they're on regular oral morphine, the as-needed subcutaneous dose needs to be calculated from their total daily dose using a recognised conversion, not just a default starting dose. If they're opioid naive, I'd use a low starting dose. I'd check renal function, because in significant renal impairment some opioids accumulate and our local guidance may suggest an alternative. I'd think about frailty, liver function and any allergies.

For nausea I'd choose an antiemetic that fits the likely cause. For agitation I'd usually use a benzodiazepine such as midazolam, but I'd also remind the team to look for reversible causes like urinary retention, pain or constipation first. For secretions I'd prescribe an antimuscarinic and explain to the family that the noise often troubles them more than the patient.

I follow our local formulary and the Palliative Care Formulary or regional guidelines, and if I'm unsure about a conversion or an unusual situation I'll ask a pharmacist or my senior to check it. I write clear indications, routes, frequencies and a maximum in 24 hours, so nurses know when to call for review.

Finally, it's not just a prescription. I'd explain to the patient, if possible, and the family what these medicines are for, address worries about morphine hastening death, and if they're going home I'd make sure the community authorisation chart, the medicines themselves and the district nurses are all in place, because a prescription that hasn't reached the house doesn't help anyone.

 

Why this answer works

The answer shows a safe, individualised approach: covering the common symptoms, adjusting for current opioid use and renal function, using local and national formularies and checking when unsure. It also recognises the practical and communication steps that make anticipatory prescribing work in the community.

 

Key points to include

• Cover pain, breathlessness, nausea and vomiting, agitation and respiratory secretions
• Individualise to current opioid dose, renal and hepatic function and frailty
• Use local formulary and recognised conversion guidance, check with pharmacist or senior
• Clear indications, frequencies and 24-hour maximums with prompts for review
• Explain the medicines to patient and family and address fears
• Make sure community paperwork and supply are in place for home

 

Common mistakes to avoid

• Reciting a fixed list of drugs and doses without individualising
• Ignoring renal function or existing opioid use
• Forgetting to look for reversible causes of agitation
• Not thinking about how medicines reach a patient at home

 

NHS values and standards

Commitment to quality of care; Compassion; Working together for patients; GMC Good practice in prescribing and managing medicines and devices

 

Further reading

• NICE guideline: Care of dying adults in the last days of life
• Palliative Care Formulary
• GMC Good practice in prescribing and managing medicines and devices
• Your local or regional palliative care symptom control guidelines

 

 

Question 5: A patient on the hospice unit asks you to give them something to end their life. How would you respond?

Clinical Scenario question  ·  Clinical Scenario

 

What the interview panel is assessing

The panel wants to see a compassionate, non-judgemental response that explores the suffering behind the request, alongside a clear understanding of the current legal position in the UK. They are also looking for a safe check of mood and risk, and for you to involve the team and seek support.

 

Model answer

The first thing I'd want the patient to feel is that it's safe to have said it. People often carry that thought for a long time before they say it out loud, so I'd sit down, not look shocked, and say something like, 'Thank you for telling me. Can you help me understand what's making you feel this way?'

In my experience a request like this is usually about suffering. It might be uncontrolled pain or breathlessness, fear of what dying will be like, feeling a burden, losing independence or dignity, or depression. So I'd explore it gently and properly. I'd ask about symptoms, about what they fear most, and about mood, including whether they've had thoughts of harming themselves, because that's part of a safe assessment.

I'd also be honest about what I can and can't do. As things stand, I cannot deliberately end someone's life or help them to end it; doing so is unlawful in the UK. Parliament has been considering assisted dying legislation, and I'd keep up to date with where that stands, but I'd never act outside the law as it is today. What I can say, and mean, is that we won't abandon them. We can work hard on the symptoms, they can refuse treatments they don't want, including things like antibiotics or artificial feeding, and we'll make sure they're comfortable as they die.

Then I'd act on what I've found. That might be reviewing analgesia, involving our psychologist or liaison psychiatry if I'm worried about depression, asking the chaplain or spiritual care team to see them, or arranging a conversation with family if the patient wants that. I'd document the conversation carefully and tell my consultant and the MDT, because nobody should hold that alone, me included.

If they want to talk about it again, I'd keep the door open. Often the request fades as symptoms and fears are addressed, but even when it doesn't, the person deserves to be listened to rather than shut down.

 

Why this answer works

The answer responds to the person before the law, exploring the suffering behind the request and assessing mood and risk safely. It states the current legal position clearly without being dismissive, and offers what can lawfully be done. Candidates should check the up-to-date status of assisted dying legislation in England and Wales, Scotland and other UK nations before interview.

 

Key points to include

• Respond calmly and without judgement, thank them for telling you
• Explore the suffering behind the request: symptoms, fear, burden, mood
• Assess for depression and risk of self-harm safely
• Be honest that intentionally ending life or assisting suicide is currently unlawful
• Explain what can be done, including the right to refuse treatment and good symptom control
• Involve the MDT, document carefully and seek senior support

 

Common mistakes to avoid

• Shutting the conversation down by quoting the law first
• Showing visible shock or discomfort
• Agreeing to anything unlawful or hinting at it
• Not assessing mood or risk
• Handling it alone without telling the team

 

NHS values and standards

Compassion; Respect and dignity; Everyone counts; GMC Good Medical Practice; GMC Treatment and care towards the end of life

 

Further reading

• GMC Treatment and care towards the end of life
• Suicide Act 1961
• Mental Capacity Act 2005
• Association for Palliative Medicine guidance on responding to a desire to die
• Current parliamentary position on assisted dying legislation in your nation

 

 

Question 6: Which NHS value matters most to you in palliative care, and can you show us how you've lived it?

NHS Values question  ·  NHS Values

 

What the interview panel is assessing

The panel wants to know that you understand the NHS values and can connect one of them to real behaviour in end of life care. They want a specific example, not a definition, and a reason why that value matters in this specialty in particular.

 

Model answer

The six NHS values are working together for patients, respect and dignity, commitment to quality of care, compassion, improving lives and everyone counts. In palliative care I think respect and dignity is the one I come back to most, because people near the end of life lose so much control that small things become huge.

I'm thinking of a woman I looked after on a hospital ward who had motor neurone disease and very limited speech. She used a communication board, which was slow, and I'd noticed that on ward rounds people tended to talk to her husband instead of to her. One morning she was being asked about a gastrostomy, and the conversation was happening over her head.

I asked the team if we could come back after the round, and I went back with the speech and language therapist and gave her the time to answer properly. It took nearly forty minutes. It turned out she'd thought about it a lot and didn't want the tube, and she'd already started writing an advance decision. Her husband hadn't realised how strongly she felt. We supported her to complete the advance decision properly, and her wishes were respected later when she became more unwell.

What stayed with me was how easily we could have made a decision for her because it was quicker. Respect and dignity, to me, means giving people the time and the means to be heard, especially when communication is hard, and then making sure what they've told us actually shapes their care. It's also about the small things, like knocking, using the name someone prefers and keeping them covered during care, even when they're unconscious.

I think that value links to the others. When someone feels respected, you've usually also shown compassion and worked together with them, and that's really what palliative care is.

 

Why this answer works

The candidate names all six values accurately, chooses one and anchors it in a specific example involving capacity and an advance decision. The reflection shows why dignity matters particularly at the end of life and links it to everyday practice.

 

Key points to include

• Name the NHS values accurately
• Choose one and explain why it matters in palliative care
• A specific, realistic example with your actions
• What changed for the patient as a result
• Reflection on how it shapes your practice day to day

 

Common mistakes to avoid

• Listing all the values with no example
• An example where the patient is barely present
• Choosing a value but describing a different one
• A vague example with no outcome

 

NHS values and standards

Respect and dignity; Compassion; Working together for patients; GMC Good Medical Practice

 

Further reading

• NHS Constitution for England
• Mental Capacity Act 2005 Code of Practice (advance decisions to refuse treatment)
• GMC Good Medical Practice

 

 

Question 7: During a home visit you become concerned that a frail patient with advanced heart failure is being neglected by the relative who cares for them. What would you do?

Safeguarding question  ·  Safeguarding

 

What the interview panel is assessing

The panel is assessing whether you recognise adult safeguarding concerns in a palliative care context and know how to act under the Care Act 2014. They want to see you balance the patient's wishes and capacity with your duty to protect, and to avoid assuming the worst about stressed carers.

 

Model answer

I'd start with the patient, because my first concern is whether they're safe right now. Say I visited with the community specialist nurse and found the patient in soiled sheets, with no food or drink within reach, a pressure sore that hadn't been reported, and medicines that clearly weren't being given as prescribed. If there was immediate risk, for example they were very unwell and alone, I'd make sure they got urgent care straight away.

If they were able to talk with me privately, I'd ask gently how things are at home, how they feel about the care they get and whether they feel safe. I'd assess their capacity for decisions about their care and living arrangements, because under the Care Act they're at the centre of the process and, where they have capacity, their wishes carry real weight.

I'd also try to understand the carer's side. In palliative care, neglect is often the result of an exhausted, frightened relative who's out of their depth, rather than deliberate harm. That doesn't make it acceptable, but it often points to the solution, such as a carer's assessment, a package of care, hospice day services or respite.

Even so, I wouldn't sit on it. I'd discuss it with the safeguarding lead and my consultant the same day, and if I had reasonable cause to suspect neglect I'd raise a safeguarding concern with the local authority in line with our policy. Making safeguarding personal means I'd tell the patient what I'm doing and why, unless that would put them at more risk. I'd also inform the GP and district nurses and document exactly what I saw, what the patient said in their own words, and what I did.

After that, the plan would be shared. The patient's symptom control and comfort still matter, so I'd keep reviewing them, and I'd be ready to escalate again if things didn't improve.

 

Why this answer works

The answer prioritises immediate safety, then puts the patient's voice and capacity at the centre as the Care Act requires. It recognises carer strain as a common cause without excusing neglect, and describes escalation through the safeguarding lead and local authority with clear documentation.

 

Key points to include

• Check for immediate risk first
• Speak to the patient privately and assess capacity
• Consider carer strain without excusing neglect
• Discuss with the safeguarding lead and raise a concern with the local authority
• Keep the patient informed in line with Making Safeguarding Personal
• Accurate documentation and sharing with GP and community team

 

Common mistakes to avoid

• Assuming the carer is deliberately abusive
• Doing nothing because the patient is dying anyway
• Ignoring the patient's own views and capacity
• Not documenting what was seen and said

 

NHS values and standards

Everyone counts; Respect and dignity; Compassion; GMC Protecting children and young people and GMC Good Medical Practice

 

Further reading

• Care Act 2014 and statutory guidance
• Mental Capacity Act 2005
• Making Safeguarding Personal
• Your trust or hospice adult safeguarding policy

 

 

Question 8: A dying patient's children disagree strongly about whether he should go back on antibiotics and IV fluids. How would you handle this?

Conflict question  ·  Conflict

 

What the interview panel is assessing

The panel wants to see that you can calmly manage family conflict while keeping the patient's wishes and best interests at the centre. They are testing your understanding of the Mental Capacity Act, the role of family in decision making and when to seek senior or legal help.

 

Model answer

I'd remind myself first that conflict like this almost always comes from love and fear. One child might feel that stopping treatment means giving up on their dad; another might have promised him he wouldn't suffer. Neither is being difficult on purpose.

Before the meeting I'd get clear on the medical facts with my consultant and the team. Is there a realistic chance antibiotics and fluids would help him, and what would the burdens be? I'd also check whether he has capacity for this decision, whether there's a valid advance decision to refuse treatment, a lasting power of attorney for health and welfare, or a ReSPECT form that records his wishes.

If he lacks capacity and there's no attorney or valid advance decision, the decision is a best interests decision made by the responsible clinician. The family's role is really important, but it's to help us understand what he would have wanted, not to choose for him. Explaining that gently can take a lot of pressure off them, because nobody is being asked to decide whether their father lives or dies.

I'd arrange a family meeting in a quiet room with a senior colleague and a nurse who knows him. I'd start by asking each of them what they understand about how he is, and what he was like before he got ill, what he valued and what he'd said about this kind of situation. Often that's where common ground appears. Then I'd explain honestly what we think the treatment can and can't do. If they still disagree, I'd acknowledge it respectfully, and sometimes a time-limited trial with clear review points is a reasonable way forward if it's in his best interests.

Throughout, I'd keep him comfortable and make sure his care doesn't stall while people argue. If disagreement persisted and couldn't be resolved, I'd involve my consultant, consider a second opinion, and seek advice from our legal team about whether the Court of Protection is needed. I'd document the discussion, the reasoning and the decision carefully.

 

Why this answer works

The answer shows empathy for the family, a clear grasp of the Mental Capacity Act framework, including advance decisions, attorneys and best interests, and practical conflict resolution through a structured family meeting. It also knows when to escalate to senior, second opinion or legal routes.

 

Key points to include

• Recognise the emotion behind the conflict
• Clarify the clinical facts and the patient's capacity
• Check for an ADRT, LPA for health and welfare or ReSPECT form
• Explain that family inform a best interests decision rather than make it
• Structured family meeting with senior support, exploring the patient's values
• Escalate to second opinion or legal advice if unresolved, and document

 

Common mistakes to avoid

• Telling the family they get to decide
• Siding with the loudest relative
• Letting comfort care stall during the disagreement
• Not mentioning the Mental Capacity Act or best interests

 

NHS values and standards

Working together for patients; Respect and dignity; Compassion; GMC Treatment and care towards the end of life

 

Further reading

• Mental Capacity Act 2005 and Code of Practice
• GMC Treatment and care towards the end of life
• GMC Decision making and consent
• ReSPECT process guidance (Resuscitation Council UK)

 

 

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