Tuesday, 15 January 2013

Liverpool Care Pathway - "A Devil In Disguise..."

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Daily Mail report on 60,000 people being put on the dying pathway
Ghostrider                                              31/12/2012 at 09:55
I never believe what the newspapers say, which is why half the time i dont read them, and today proved that. There was a report about 60,000 people being put on the dying pathway, also known as the Liverpool Care Pathway (LCP). For those not in the know, it is a document that nurses and doctors use when the patient in a hospice / hospital are deemed to be very poorly, and have not got long to live.
In real terms, and as a hospice nurse, all it means is that we are condensing down all the care plans we have to write, into one document. If we put someone on the LCP, it is after families have been spoken too, where we have told them, that their loved one is less well, and time is short. We dont always tell them we are putting the patient on the LCP, since in real terms, it means nothing. The care, the treatment, doesnt change. It is just a document for us, that also allows future nurses looking at the care notes, to be able to access certain information quicker, and acts as a guide, that this particular patient will need more observation than others.
If people go on it, certainly from a hospice perspective, treatment such as infusions, further radiotherapy etc, will have been discussed on initial contact to the ward. So like i say the LCP doesnt change anything.
Well i just thought i would write this here, since i am not on any other websites, Facebook etc, but for those who saw that headline today, dont be afraid, that we are condoning people to death. Its never that straight forward. But for those who want to know more, feel free to email me here.


"If we put someone on the LCP, it is after families have been spoken too, where we have told them, that their loved one is less well, and time is short."

"We dont always tell them we are putting the patient on the LCP, since in real terms,...it means nothing."

I see, you speak to them, but you don't always tell them...

Because, "in real terms, it means nothing..."

"It doesnt change anything."

This is a Professional LCP Clinician.

This is Norman Lamb in The Telegraph -
"...doctors should not use the term [Liverpool Care Pathway] because it “means nothing” to patients."
Well, it certainly means something to the families of those who have perished on it!

Mr. Lamb said,
"he was “uncomfortable” using the word “pathway” in relation to death. He has asked a panel of experts, who will be undertaking a wide-ranging review of the guidelines, to come up with an alternative."
And so you should be "uncomfortable", Mr. Lamb. It's a 'Brand' with a brand image. It's a tarnished image, just as is the NHS.

But if you change its name,it's still the same; it's still the Devil in Disguise...!

This is The Telegraph -

Liverpool Care Pathway needs name change, says Norman Lamb

The Liverpool Care Pathway - the controversial set of clinical guidelines for those close to death - should undergo a name change, a minister has suggested.

Liverpool Care Pathway needs name change, says Norman Lamb

7:00AM GMT 15 Jan 2013

Norman Lamb, the Care Services Minister, said doctors should not use the term because it “means nothing” to patients.
He also said he was “uncomfortable” using the word “pathway” in relation to death. He has asked a panel of experts, who will be undertaking a wide-ranging review of the guidelines, to come up with an alternative.
Relatives of those put on the pathway have raised considerable concerns over its use in recent months.
Many have said they were not told loved-ones were put on it, while others have claimed patients were left in clear distress after hydration was withheld.
A small number of doctors has even argued the pathway has been used to hasten death - a claim strongly rejected by most medics.
In November Mr Lamb announced the review of the LCP, named because it was developed at the Marie Curie Institute in Liverpool, saying it was "unacceptable" that patients were being put on it without their loved-ones being told.
He has now asked Baroness Julia Neuberger, the cross-bench peer, to chair the review.
Speaking as he announced the appointment, Mr Lamb said: “I have a problem with using a term like ‘Liverpool Care Pathway’.
“What on earth does it mean? I don’t want the term used when dealing with members of the public. The ‘Liverpool Care Pathway’ means nothing to them.”
He continued: “If you referring to a ‘pathway’ in relation to death, I feel uncomfortable with that, because patients won’t understand it.”
Mr Lamb insisted his suggestion to rename the LCP - sometimes coined the ‘death pathway’ - was not an empty rebranding exercise, but an attempt to ensure doctors explained it properly to patients and loved-ones.
He also said the appointment of Baroness Neuberger, a rabbi who has written on the subject of caring for the dying, would ensure a “faith perspective” was brought to the review.
He is giving her until the summer recess to complete the report, saying he did not want to set an “artificial and overly-tight” deadline.


  1. Norman Lamb, with all due respect you should be representing the people who elected you, not the self serving, narcissistic, deluded face of the NHS.

    The NHS has treated patients with what amounts to the utmost contempt and all that has come from the politicians of this Government is exactly the same.

    You cannot change the Liverpool Care Pathway, because it is the very practices which are wrong. Practices, I might add which are unusually near to the Aktion T4 euthanasia programme which Adolf Hitler began in 1934. Anyone who has any doubts, google it and look at the methodology.

    Initially before gassing came about, death would be by starvation, dehydration and either a withdrawal of medications, or indeed an overdose of medications. Nice to see our NHS is alive and kicking and keeping in with Hitler's own programme for killing the elderly and infirm.

    So Mr hypocrite (Lamb) may I ask when this horrible Government is actually going to ban the use of the Liverpool Care Pathway outright? Or are you going to continue to snuggle up nice and cosy to the NHS, bigots, narcissists and propagandists?

    You have a choice here, you either side with the people, or simply at the next election end up as the Sunday roast yourself. The people of this country are not prepared to stand by and see this abomination of a care system kill its elderly in a cruel and inhumane manner. That is, at least, those of us who are not deluded by their own sense of self grandeur and importance as this NHS system now is!

    I am so sorry for anyone who has suffered in this manner.

    Say No To The Liverpool Care Pathway - Sliepnir2006 You Tube

  2. My understanding of the Liverpool Care Pathway is that it aims not to shorten life or prolong it but continues to give patients food and drink by mouth up until these are refused (which they tend to be first food then drink towards the end of life). The problem I have with this is that life could be prolonged and enhanced with the use of intravenous intervention to administer vits/minerals and glucose which is not part of the LCP as it claims this is an artificial prolonging of life.

    The problem I see here is in saying it is the patient's 'choice' whether to eat food and drink is there is a catch 22 here... many terminal illnesses (e.g. cancer + HIV) can cause anemia, this causes a general weakness and a diminished will to live, also zinc deficiency can cause a lack of appetite. So if the patient were administered these intravenously, it is likely their will to live would become much stronger and that they would continue to eat and drink independeently for longer with these supplements.

    The question then as to whether patients should be put on the LCP should take into consideration if the patient is in unbearable pain or discomfort, in which case the LCP could be a patient choice.

    I believe that if a patient would like a vit/min enfusion intravenously, this should be a choice put to them before embarking on the LCP and unless stipulated by the patient, the LCP should not be the way to automatically go.