The Care Pathway
"Under the scheme, doctors and nurses collectively agree that there is no possibility of recovery. They then remove beneficial medicines and invasive medication, such as intravenous drips. They may also sedate the patients and withhold food and drink."Mike Richards, who was involved in the introduction of the Liverpool Care Pathway, said it was "essential" that medical staff were skilled in deciding who should be put on the scheme for those at the end of their lives.
It follows concerns that patients with terminal illnesses are being made to die prematurely because they are incorrectly placed on the pathway, which can mean the withdrawal of food and fluids.
On September 2009, six palliative care experts wrote to a national newspaper saying that prediction of death is an inexact science and that decisions are made under the Pathway “without regard to the fact that the diagnosis could be wrong.” They stated that the LCP results in some patients dying prematurely and that a “national wave of discontent is building up, as family and friends witness the denial of fluids and food to patients."
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1999
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| The NHS is accused of "involuntary euthanasia" |
A senior consultant's claim that elderly patients are being left to starve to death in NHS hospitals has been dismissed by Health Secretary Alan Miburn as "ludicrous".
Dr Adrian Treloar, a consultant in old age psychiatry and senior lecturer in geriatrics at the Greenwich Hospital and Guys', King's and St Thomas's Hospitals in London, said there was an unofficial policy of "involuntary euthanasia".
He said patients were being denied appropriate treatment partly because of the huge pressures on beds building up in the health service.
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| Dr. Adrian Treloar claims the elderly do not always get proper care. |
Police are reported to be investigating 60 cases involving pensioners who died after allegedly being deprived of food and water by hospital staff.
Detectives in Derbyshire have filed a report, said to run into several thousand pages, to the Crown Prosecution Service, after a 22-month inquiry at the Kingsway Hospital in Derby
The investigation is understood to centre on the deaths of around 30 elderly patients.
A pressure group formed by relatives, SOS NHS Patients in Danger, is considering taking the issue to the European Court of Human Rights.
But, speaking on the Today programme on Wednesday, Mr Milburn said: "If the allegation is that the NHS is routinely starving elderly people to make more room in hospitals it is simply untrue, it is ludicrous, it is scaremongering.
"Frankly, it is also an attack on the integrity of doctors and nurses who spend most of their working day caring for elderly patients."
A pressure group formed by relatives, SOS NHS Patients in Danger, is considering taking the issue to the European Court of Human Rights.
But, speaking on the Today programme on Wednesday, Mr Milburn said: "If the allegation is that the NHS is routinely starving elderly people to make more room in hospitals it is simply untrue, it is ludicrous, it is scaremongering.
"Frankly, it is also an attack on the integrity of doctors and nurses who spend most of their working day caring for elderly patients."
 It is very clear that the elderly do not always get all the care they need  |
| Dr Adrian Treloar |
He was also quoted in an interview with the Daily Telegraph as saying "there may be a tendency" to limit care for the elderly who are very seriously ill to relieve severe pressure on NHS beds.
He claimed that old people who start to resist early
discharge are seen as "an encumbrance".
Dr Treloar said he had heard many allegations from families of relatives being denied treatment and left to die in NHS wards.
BMA guidelines
 Dr Michael Wilks said the guidance was drawn up to end confusion |
The guidance says: "Doctors should have the final say over whether treatment including feeding and giving water is in the patient's best interest. It is not always appropriate to prolong life."
Dr Michael Wilks, chairman of the BMA's ethics committee, said the guidelines were drawn up because of widespread confusion among doctors about what was acceptable practice.
"We tried to help doctors work through a clinical framework, working out whether the particular treatment - which might include artificial nutrition and hydration - was in fact of benefit to the patient.
"When you have a treatment that is of no further benefit you have an ethical responsibility to at least consider withdrawing it."
Dr Wilks said it still unacceptable for doctors to withdraw treatment specifically to kill patients.
Call for government action
The charity for the elderly, Age Concern, demanded urgent government action and accused the NHS of adopting a culture of ageism and rampant discrimination.
Sally Greengross, Age Concern director general, said: "We have been contacted by thousands of people who have complained about the treatment of the elderly in the NHS system.
"What this senior consultant has said links very closely with our own findings. We need urgent legislation to prevent this discrimination."
Dr Michael Wilks, chairman of the BMA's ethics committee, said the guidelines were drawn up because of widespread confusion among doctors about what was acceptable practice.
"We tried to help doctors work through a clinical framework, working out whether the particular treatment - which might include artificial nutrition and hydration - was in fact of benefit to the patient.
"When you have a treatment that is of no further benefit you have an ethical responsibility to at least consider withdrawing it."
Dr Wilks said it still unacceptable for doctors to withdraw treatment specifically to kill patients.
Call for government action
The charity for the elderly, Age Concern, demanded urgent government action and accused the NHS of adopting a culture of ageism and rampant discrimination.
Sally Greengross, Age Concern director general, said: "We have been contacted by thousands of people who have complained about the treatment of the elderly in the NHS system.
"What this senior consultant has said links very closely with our own findings. We need urgent legislation to prevent this discrimination."
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The Care Pathway
"Under the scheme, doctors and nurses collectively agree that there is no possibility of recovery. They then remove beneficial medicines and invasive medication, such as intravenous drips. They may also sedate the patients and withhold food and drink."
Mike Richards, who was involved in the introduction of the Liverpool Care Pathway, said it was "essential" that medical staff were skilled in deciding who should be put on the scheme for those at the end of their lives.
It follows concerns that patients with terminal illnesses are being made to die prematurely because they are incorrectly placed on the pathway, which can mean the withdrawal of food and fluids.On September 2009, six palliative care experts wrote to a national newspaper saying that prediction of death is an inexact science and that decisions are made under the Pathway “without regard to the fact that the diagnosis could be wrong.” They stated that the LCP results in some patients dying prematurely and that a “national wave of discontent is building up, as family and friends witness the denial of fluids and food to patients."
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2011
Shortage of money is not the problem, but a failure to look beyond a patient's clinical needs, says the NHS Ombudsman
Thursday, 26 May 2011
Doctors caring for elderly patients in hospital are being forced to prescribe water for them in order to ensure they have enough to drink.
Inspectors from the Care Quality Commission (CQC), the NHS watchdog, found nurses sometimes left patients so thirsty that the only way for doctors to ensure they had enough liquid was to add "drinking water" to hospital medication charts.
The revelation comes in the first reports from the CQC into dignity and nutrition of elderly people treated by the NHS, which reveals a failure to attend to the most basic requirements of care. The Health Secretary, Andrew Lansley, who ordered the reports, said the failings were "unacceptable".
Of the first 12 NHS trusts inspected, three failed to meet the essential standards required by law of respecting and involving people in their care and meeting their nutritional needs. Less serious concerns were identified in three further hospitals, giving a 50 per cent overall failure rate. The reports are the first of 100 inspections carried out, which are continuing. They follow a decade of investigations that have revealed an NHS riddled with ageist attitudes, in which elderly patients are neglected, poorly treated and marginalised. Shortage of money and resources is not the problem but rather, as the NHS Ombudsman said in a scathing report last February, an "ignominious failure" to look beyond a patient's clinical condition and respond to their social and emotional needs. A spokesman for the CQC said the 50 per cent failure rate was likely to be reflected nationally.
The worst offender was Alexandra hospital, Redditch, Worcester London and Ipswich hospital also failed to meet the standards required by law.
At Alexandra hospital, inspectors saw meals being served to patients who were asleep. Trays were left out of reach, patients were not offered help to cut up their food and one patient was seen trying to tear a tomato apart with their fingers. Nobody was routinely offered handwashing before or after eating. Although the trust said it offered a choice of dishes, one patient who declined a meal had it taken away without being offered any alternative.
Medical staff explained how they prescribed drinking water on medication charts "to ensure people get regular drinks". Inspectors saw examples of this being done and were told it "worked". Ward staff said they were aware of drinking water being prescribed and that this was done to "make sure people get enough fluids".
The reports on the 12 trusts also highlight how patients were not weighed, making it impossible to check if they were losing weight. Malnutrition is a major problem among elderly patients, affecting 185,000 discharged from hospitals in England
Others were not treated with dignity, involved in their own care or were spoken to in a condescending manner. One man said hospital staff talked to him "as if I'm daft".
Mr Lansley said: "The inspection teams have seen some exemplary care, but some hospitals are not even getting the basics right. That is unacceptable."
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The Care Pathway
"Under the scheme, doctors and nurses collectively agree that there is no possibility of recovery. They then remove beneficial medicines and invasive medication, such as intravenous drips. They may also sedate the patients and withhold food and drink."
Mike Richards, who was involved in the introduction of the Liverpool Care Pathway, said it was "essential" that medical staff were skilled in deciding who should be put on the scheme for those at the end of their lives.
It follows concerns that patients with terminal illnesses are being made to die prematurely because they are incorrectly placed on the pathway, which can mean the withdrawal of food and fluids.On September 2009, six palliative care experts wrote to a national newspaper saying that prediction of death is an inexact science and that decisions are made under the Pathway “without regard to the fact that the diagnosis could be wrong.” They stated that the LCP results in some patients dying prematurely and that a “national wave of discontent is building up, as family and friends witness the denial of fluids and food to patients."
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