Friday 25 January 2013

Liverpool Care Pathway - Dementia: The 2013 CQUIN


This is Mail Online -




One in six patients put on controversial care pathway last year has dementia

  •  Liverpool Care Pathway aims to reduce suffering in the last hours and days of a dying person's life
  • Some 130,000 people are believed to be placed on the pathway every year

At least 20,000 people with dementia are put on the controversial Liverpool Care Pathway every year, Parliament has been told.

A national audit suggests that one in six of the people placed on the pathway each year have either a primary or secondary diagnosis of Alzheimer’s, or another form of dementia.

Dr Philip Howard, a consultant gastroenterologist in London, said this raised huge concerns because these patients could not have been meaningfully consulted on whether life-saving treatment should be withdrawn.


Some 130,000 people are believed to be placed on the pathway every year (posed)

He said that, given the fact that another 45 per cent of people were unconscious when placed on the pathway, it meant more than half are never asked whether they want their life to come to an end.

The doctor made his explosive comments at a meeting with peers in the House of Lords.

The Liverpool Care Pathway aims to reduce suffering in the last hours and days of a dying person’s life.

MP Norman Lamb has launched an inquiry
MP Norman Lamb has launched an inquiry
Doctors can withdraw fluids and drugs from patients if they are deemed close to death.

Care services minister Norman Lamb has launched an inquiry into the way the pathway operates, following concerns that patients and relatives are often not consulted by doctors when people are placed on the scheme.

Dr Howard said: ‘There is an urgent need to restore the confidence of the public in the medical profession and of individual patients and their loved ones in their doctors and nurses.

‘The most important person on the ward round is the dying patient. We should never walk away from the dying patient – either metaphorically or literally.’

Some 130,000 people are believed to be placed on the pathway every year. Dr Howard’s figures come from a national audit carried out by the Marie Curie Palliative Care Institute in Liverpool.

Baroness Knight, who called the meeting in the Lords, said the statistics were shocking. ‘If a patient has dementia, how can it be possible for them to agree to what is put to them? What we are seeing more and more is (doctors) putting people on the pathway without saying anything to them or their relatives.’

She added: ‘What is happening is that people are now afraid to go into hospital, and that is bad for doctors and bad for medical care.’

Dr Howard called for meetings between patients, relatives and doctors about the pathway to be recorded on video, as proof that people have been properly consulted.

He said the pathway was ‘flawed in principle and practice’ because it came into play when doctors decided a person is close to death, yet there was no evidence that doctors can predict when that stage has been met.

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