Prognostication simply means predicting an outcome (Glare et al. [17]); in the care of those who are dying, patients and their families may want information about the likely time remaining before death occurs. This can be difficult to know with much certainty but is generally easier to gauge the closer death is to occurring. Although studies show that patients and their relatives tend to have different information needs regarding prognosis (relatives generally wanting more detailed information than patients, Clayton et al. [4]), it is important that these are carefully assessed to ensure that the needs of all those involved with the patient can be met. Discussions surrounding prognosis should be undertaken by professionals confident in advanced communication skills and with the appropriate experience to offer an approximation on the grounds of their clinical knowledge and experience. The principles of breaking significant news should be adhered to in undertaking discussions about prognosis.

The style and manner in which news is delivered can affect people's understanding of information, the relationship with health professionals and subsequent psychological and emotional outcomes (Street et al. [56]). Delivering news in an insensitive, rushed or otherwise unsatisfactory way is likely to be detrimental and runs the risk of longer‐term harm. The overall aim of breaking significant news should be to impart clear information that enables people to become suitably involved in decisions, whilst minimizing distress (Schofield and Butow [50]).

Girgis and Sanson‐Fisher ([16]) identified a consensus in the key aspects of the process; these included the patient's right to decide how much to know and to receive timely, accurate, clear and honest information. People should be prepared for receiving news, taking into consideration language and cultural barriers. News should ideally be given by one person in an appropriate physical environment, but involvement of other health professionals like the key nurse can be crucial to ensuring that information is clarified and emotional support maintained. People identified by the patient's preference should be invited to attend and the person delivering the news should be warm and have excellent communication skills. Finally, but crucially, the emotional impact on everyone involved should be acknowledged and managed appropriately. Delivering significant news can be both complex and stressful for health professionals (Bousquet et al. [2]).

The process can be summarized as one involving:

Self‐care and debriefing is also necessary – the stress and burden of the process is well documented and health professionals must take responsibility to attend to their own emotional needs.