Why is it that so many professional initiatives in palliative care, and for all I know healthcare in general, involve ‘tools’? Of course, this blog has been a bit nasty about ‘decision-support tools’ in the continuing care system, but the trend is widespread. The image is of the doctor or nurse rolling up at the bedside, with their little black bag, and opening it up to reveal a hammer, chisel and saw – the traditional surgical implements. ‘Ah yes, I will just hammer this nail into your arm to make the connection with your vein for this helpful syringe driver’. Perhaps nowadays it would be a smart electronic gadget, like Mr Spock’s or Dr Who’s equipment. Or the social worker tooling up (as they used to say in cowboy novels) to the home situation, with a fast-draw genogram.

But it’s all spin, of course. We say ‘tools’ to avoid having to mention that most of them involve filling in a form, sometimes a multi-page form, having asked some questions. It wouldn’t seem quite so professional to be coming up with another set of forms as a result of a research project into developing practice, so it’s toolboxes not tickboxes.