Sunday, 16 June 2013

Liverpool Care Pathway - Best Practice, Evidence-Based Record Keeping

It is Best Practice, evidence-based record keeping. It is the Liverpool Care Pathway. It is Best Practice, evidence-based record keeping. It is the...

Liverpool Care Pathway. It is Best Practice, evidence-based record keeping.

Say it enough times...

Goebbels And The “Big Lie”

Nazi propaganda chief Joseph Goebbels was the master of the “big lie” tactic in which a lie, no matter how outrageous, is repeated often enough that it will eventually be accepted as truth. Goebbels explained:
“If you tell a lie big enough and keep repeating it, people will eventually come to believe it. The lie can be maintained only for such time as the State can shield the people from the political, economic and/or military consequences of the lie. It thus becomes vitally important for the State to use all of its powers to repress dissent, for the truth is the mortal enemy of the lie, and thus by extension, the truth is the greatest enemy of the State.”

This is the Express -

London hospitals are not likely to be untypical of hospitals in the rest of the country. Requests for information often come back that no records are kept in this or that respect...


It is the Liverpool Care Pathway. It is Best Practice, evidence-based record keeping.
Freedom of Information requests sent to all 21 hospitals in London showed startling gaps in basic knowledge which, if replicated across all 178 hospital trusts in England, would indicate a major problem. 
The requests, included in the study, reveal four in 10 trusts cannot provide any information on how many elderly or vulnerable patients are currently on the LCP. 
Eighty per cent could not say how many patients had subsequently been taken off.
Report author Andrew Boff said it exposed a lack of clear, reliable and ­publicly accessible information across London. 
While not critical of the Pathway itself, he said his study indicated poor practice could go unchecked if more information was not available.
- the Express
The LCP is a document protocol. What it purports to bee and what it is appears to bee a tad divergent.

End of Life Care Co-ordination Record Keeping Guidance


Anita Hayes and Dr Bee Wee

  1. The co-ordination of care is key to providing person-centred care across professional and organisational boundaries. One reason why services might fail to meet an individual’s needs is that professionals may not have access to information about a person’s preferences and wishes for their care: this prevents effective decision making and good care at a time when they need it most.
  2. At the other end of the spectrum a person may encounter many different health and social care professionals who cannot access previous information recorded about that person, simply because the professional is operating in a different part of the care system. This can lead to frustration, lack of coordination and poor care.
  3. An electronic palliative care co-ordination system (EPaCCS) can solve this problem by allowing cross-boundary access to information about the person’s preferences and wishes, provided, of course, that the person is willing to have this information shared with relevant professionals.
  4. The End of Life Care Strategy (2008) states that “all people approaching the end of life, and their carers, should be entitled to know that systems are in place to ensure that information about their needs and preferences can be accessed by all relevant health and social care staff with their permission”.
  5. The NICE Quality Standard for End of Life Care (2011) includes a definitive statement on this issue: “People approaching the end of life receive consistent care that is co-ordinated effectively across all relevant settings and services at any time of day or night, and delivered by practitioners who are aware of the person’s current medical condition, care plan and preferences.”
  6. To achieve this, the ‘end of life care co-ordination information standard’ provides a consistent safe and reliable way of recording and communicating this information, so that professionals deliver high quality coordinated end of life care.

If the records are there, where are the records...

and what dark secret do they conceal?

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