Sunday, 11 November 2012

Liverpool Care Pathway – Anecdotal, Anecdotal, Anecdotal

Earl Howe (Parliamentary Under Secretary of State (Quality), Health; Conservative)

My Lords, there is no procedure, as there is no such inquiry. A number of organisations, led by the National End of Life Care Programme, Dying Matters and the Association for Palliative Medicine, are looking into complaints, patient experience and clinical opinion on the Liverpool Care Pathway. We do not make policy decisions based on anecdote. If the work in hand suggests cause for concern, we will respond on the basis of that evidence.

(They Work For

Here is the Bradford Telegraph & Argus -

Bradford Telegraph and Argus
Daughter hits out at treatment plan used by Royal Preston Hospital

Susan Brook who is calling for a law changeSusan Brook who is calling for a law change

A woman who says her mother was “condemned” to death after being placed on the Liverpool Care Pathway without her knowledge is calling on the Government to force hospitals to stop using the controversial programme for elderly patients.

Mother-of-three Joan Flynn, who had just become a great-grandmother, died in the Royal Preston Hospital aged 90.
Mrs Flynn, who lived in the Bolton area of Bradford for more than 50 years before moving to Lancashire, had been admitted after a fall at home.
Joan Flynn who died

Her family say she was placed on the Liverpool Care Pathway (LCP) and a ‘do not resuscitate’ order was placed on her without any consultation with her family.
When they realised what was happening they pleaded with doctors to take her off the LCP which they did.
However, Mrs Flynn died on Sunday, July 24, 2011, six days after being admitted to hospital with a suspected broken rib.
The LCP is a programme for delivering palliative care to people with a terminal illness but it has attracted negative publicity with accusations doctors are using it as a “death pathway”.
Answering questions to MPs in Parliament yesterday as Commons Leader, former Health Secretary Andrew Lansley stressed it was important patients gave consent to being placed on the pathway.
Mrs Flynn’s daughter Susan Brook, 61, of Eccleshill, said: “I watched my mother being denied food and liquid and she passed away three days before her 91st birthday.Where they were unable to do so, it would be up to their families to give informed permission, he said.
“I pleaded with the doctors and nurses to withdraw the LCP which they did 24 hours before she died, but they knew it was too late.”
Mrs Brook complained about her mum’s treatment but remained unsatisfied with the hospital’s response and has now referred the family’s concerns to the Healthservice Ombudsman.
She has also gathered hundreds of signatures on a petition calling on the Government to make it illegal for any hospital, doctor, nurse or care home to place any patient on the LCP who has not agreed and whose relatives have also not agreed for them to die this way.
“I have experienced first hand what the LCP and hospitals are doing and in my opinion they are actually killing off the elderly,” said Mrs Brook. A post-mortem examination revealed that Mrs Flynn died from heart failure.
Karen Partington, chief executive of Lancashire Teaching Hospitals NHS Foundation Trust, which manages the Royal Preston Hospital, said: “The Liverpool Care Pathway is a nationally recommended framework that aims to enable healthcare professionals to focus on patients’ needs, and maintain dignity and quality of life, in their last days and hours when death is expected.
“We always aim to ensure patients’ relatives are fully informed about the condition and planned care of their loved one.
“We have undertaken a full investigation into the care we provided to Mrs Flynn, and are assured that the clinical decisions taken were in her best interests.
“We understand that the end of life is a distressing time for families, and offer Mrs Flynn’s family our sincere condolences.”
The Nursing Times reported -

Nursing Times
A health minister has hit out at “misreporting and misinformation” about the Liverpool Care Pathway for dying patients.

Earl Howe said there had not been a single complaint to the regulator about the Liverpool Care Pathway (LCP), which recommends that in some circumstances doctors withdraw treatment, food and water from sedated patients in their final days.
His comments came after care services minister Norman Lamb announced today that a new legal obligation in the NHS constitution would make “clear and explicit” the right of patients and their families to be informed over end-of-life treatment decisions.
At question time in the House of Lords, Tory Baroness Knight of Collingtree said: “Large number of people with personal experience of how the LCP is operating complained that their relatives were denied hydration in hospital and died in acute pain and discomfort with no knowledge whatsoever or agreement of having been put on this pathway.”
She asked Lord Howe: “Are you aware that if relatives step in in time and give their dear ones help and water patients have often survived? One rang me a few days ago and she is now going on a cruise.”
She said there should be a “truly independent” inquiry and not one carried out by “vested interests”.
Lord Howe told her: “There has been an enormous amount of misreporting and misinformation around the Liverpool Care Pathway, which has been endorsed publicly in a consensus document by 22 of the leading organisations and patient organisations in this area including Marie Curie.
“Some of those organisations are looking carefully at the reports you mentioned. It is noticeable that not a single complaint has reached the regulators in this area, which I suggest indicates there may be less substance to some of these stories than first meets the eye.”
He added there was “no room for complacency in a matter of this kind” and a number of organisations were looking into the system.
But he told peers: “We do not make policy decisions based on anecdote if the work in progress suggests a cause for concern we will respond on the basis of that evidence.”

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