Wednesday, 17 October 2012

Liverpool Care Pathway – The LCP Hit List

The culture of death is creeping into every aspect of daily life. Of course, dying is a part of life, but the major part of life is living.

The LCP and its protocols are creeping into every compartment of care. The St. Mungo Project for the homeless in London uses the Liverpool Care Pathway in its operation. Engaging with these lost stragglers of society, staff are encouraged to join with clients on the subject of death and dying and identify those who need to receive end of life supportive care.

The National End of Life Care Programme has published a ‘practical guide’ to support hostel staff in this regard.

Staff are encouraged to follow such LCP Protocols as:
Ask yourself the question “Would I be surprised if this person were to die at some stage in the near future?”
Those on the street are, generally, on a downward spiral that, if not halted or reversed, will send them to an early grave. Those engaged in their support, generally, become involved in this area of social care to lend assistance and make a difference. ‘Supportive discussion’ with the client about their wishes for end-of-life care is not the ‘norm’ for what one might consider to be ‘supportive’ discussion.

A Worrying Development

At a surgery near you, they are drawing up a hit list. Your GP is now a Hitman employed by the NHS (National-socialist Health Service) and the State tasked with marking down 1 in every 100 for selective termination. Selective termination. Is that too strong an expression to use? No. What was just covert is now open and blatant.

The National End of Life Care Programme advice given to the St. Mungo's staff is being adopted by your GP. But supportive discussion with the patient about their wishes for end-of-life care is not the ‘norm’ for what one might consider to be ‘supportive’ discussion.

There are more sinister aspects to this tale. Those selected for this honour to perform their civic duty and die are to be encouraged to draw up a Living Will. No doubt, this Living Will could include a decision to make their mortal remains available for donor harvesting. 

If you want to donate your organs and tissues after death, you should consider yourself a potential donor regardless of your age or medical history. There are no absolute guidelines when it comes to age, and your medical condition at the time of your death is more important than your past history. You're never too old to donateThis could be a 100% plus all round in savings for the NHS.

And having been earmarked for termination, the first thing they'll insert in your notes when the selected use-by date comes due is a DNR notice!

Here is The Telegraph -

Family doctors asked to identify patients likely to die

Family doctors are being asked to identify those of their patients that are likely to die so that they can be singled out for "end of life" care, it has been revealed.

Doctor using stethoscope
The advice giving doctors and health and social workers new guidance on how to select candidates was launched by Liberal Democrat Care Minister Norman Lamb at a conference on end-of-life care Photo: ALAMY

GPs could then ask patients where they would prefer to die and tell them they can draw up a "living will" to instruct doctors to withdraw life-saving treatment if they become incapacitated in hospital.
The advice giving doctors and health and social workers new guidance on how to select candidates was launched by Liberal Democrat Care Minister Norman Lamb at a conference on end-of-life care.
It states that one in 100 of all doctors' patients are expected to die each year – on average 20 per practice, reports the Daily Mail.
Around 70 per cent to 80 per cent of all deaths are likely to benefit from planned end-of-life care, it states.
But critics say it is a cost saving message and is in danger of creating quotas and a "self-fulfilling prophecy".
"Have your local practices identified the one per cent of their practice population who may be likely to die in the next year?" it reads.
"Doctors are told to pick out such patients during routine consultations that show 'indicators of frailty and deterioration' and are told that 'older people are a priority to consider".
They are also told to use feedback from district nurses or hospital consultants, while patients in care homes should be "actively considered for your register", the advice states.
Information for GPs on what happens to such patients said they would be "less likely to be subject to treatments of limited clinical value".
It added that a quarter of all hospital beds are occupied by dying people and said that four in ten have no medical need to be there.
If each had one less emergency admission into hospital in their last weeks and months, that would save the NHS £1.35 billion a year, the material said.
The advice tells doctors: "After several years of falling, the death rate is about to increase again as the baby boomers reach old age. This is a bad situation, which is going to get worse unless we act now."
The register plan emerged amid a growing controversy over the Liverpool Care Pathway (LCP), the method adopted by hospitals with the aim of easing the last hours of those judged to be dying.
Health ministers yesterday endorsed the LCP – which can involve sedation and the withdrawal of food, fluids and lifesaving treatment from patients, – releasing a report which said it was 'best practice' and recommended by the NHS.
The Health Department's latest report also backs the campaign for GP "death lists".
Over the past week, some families have told the Daily Mail that they believe their loved ones were wrongly put on the LCP by hospitals when they were not in fact dying.
One senior NHS consultant, Professor Patrick Pullicino, has criticised it as a "self-fulfilling prophecy".
But Mr Lamb told the conference yesterday that he was delighted with the latest toolkit, saying that while "end-of-life care in hospital is often not as good as it could be", it should be 'as comfortable and dignified as we can possibly make it'.

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