Over the last 25 years the theory, practice, research evidence base, and clinical applications have developed, generating widespread adoption of the principles of public health approaches to palliative care. The essential principles of prevention, harm reduction, early intervention, and health and wellbeing promotion can be applied to the universal experience of end of life, irrespective of disease or diagnosis. Compassionate communities have become a routine part of the strategy and service development in palliative care, both within the UK and internationally.

Palliative care has become increasingly professionalised, focused around symptom science. With this emphasis on minimizing the harms of physical, psychological, and spiritual stress, there has been a loss of how cultures and communities look after their dying, with the wider social experience of death often sidelined in the professionalisation and medicalisation of care. However, the people we know and love in the places we know and love make up what matters most for those undergoing the experiences of death, loss, and care giving.