WP1:  Inclusion Criteria:  Adult (18 years and over) patients with ReSPECT form completed in previous 6 months Carer/next of kin of adult patients without capacity, associated with the ReSPECT form completion General Practitioners involved in ReSPECT process Nursing and care home managers  Exclusion Criteria:  Patients in final stages of terminal illness (expected to die within next four weeks) Patients currently in hospital  WP2 interviews  Inclusion criteria:  Faith leaders  Exclusion criteria:  None  WP2 surveys  Inclusion criteria:  Members of the public General Practitioners  Exclusion criteria:  None  WP3:  Inclusion criteria:  Adult (18 years and over) patients with a ReSPECT form completed in the previous 12 months  Exclusion criteria:  Patients who opt-out Patients in final stages of terminal illness (expected to die within next four weeks)  WP4:  Members of patient and carer organisations Community and faith groups Relevant professional organisations Policy makers and regulatory bodies Members of the national ReSPECT working group