Liverpool Care Pathway - End Of Days!

"End of Days" - A name with a nice apocolyptic feel to it...
Rebranding, rebranding, rebranding! But for now, it's business as usual.

Rebranding, rebranding, rebranding.

Our top priority was, is and always will be rebranding, rebranding, rebranding.[With no apologies to Tony Blair]

More Care, Less Pathway...

Something is missing. Something has been overlooked. There is no mention of those who were consigned on this Pathway who were not dying!

The insults and the denial continues even in the face of all the evidence to the contrary. This is Marlborough News Online –

Tony Millett on 17 July 2013

Marlborough News Online understands that NHS leaders have been surprised by the vehemence of responses from clinicians who think reform would be better than phasing out the LCP.  We may find there will be a re-branding put in place rather than a totally new system.

The NHS has a whole list of care ‘pathways’ for all manner of illnesses and conditions, but not all of them play so easily into the hands of headline writers.

That is an insult to all those who have - and are - perishing on this pathway.

Mr. Millett, I could tell you where to put your rabid journalese, but I am too polite to use such language on these pages. I had expected more of a provincial column writer. It would appear that hack journalism isn't exclusive to Fleet Street...

The review – led by Lady Neuberger – found it was not the pathway itself that was to blame. But serious faults lay in how it was in some cases administered, in some cases lack of appropriately compassionate care, in some cases lack of suitably trained staff, too junior staff taking decisions and a ‘week-days-only’ culture.

There had also been accusations that too often relatives were not consulted properly or told enough about the pathway.  And the review heard some harrowing examples of bad practice and very poor nursing.

Lady Neuberger said: “Ultimately it is the way the LCP has been misused and misunderstood that had led to such great problems.”  She said it was now too late to salvage the LCP.

Prospect Hospice (in Wroughton) which takes patients from the Marlborough area, and Great Western Hospital have been co-operating on end of life care for the past six years. Now the findings have been digested and discussed, they have both issued statements welcoming the report:

Prospect Hospice welcomes the recommendations of More Care, Less Pathway: A Review of the Liverpool Care Pathway, and the highlighting of the broader issues regarding the care of dying people that this has led to.

Prospect Hospice’s Chief Executive, Angela Jordan, said: “At Prospect Hospice we want to see the very best in end-of-life care for everyone, and the recommendations contained in this review, if implemented, will improve the experiences of dying people.”

“We also believe that individualised patient care is the most important aspect of helping to bring about a good or better death, and developments that share this ethos is broadly welcomed.”

She added: “This belief led us to developing a partnership with Great Western Hospital where, for the last six years, a small team of Prospect Hospice specialist nurses and our shared medical consultant have supported the provision of care to people at the end of their lives.”

“In many instances their work has meant patients have been able to return home, with our support, when that has been their wish. The right care at the right time and in the place of a person’s choosing is the central aim of all that we seek to achieve.”

Great Western Hospitals NHS Foundation Trust's Medical Director, Dr Alf Troughton, said: “We welcome the review and will work to support its recommendations. Our absolute priority when caring for patients who are dying, is to provide personal, dignified and compassionate care, to both the patient and their loved ones, regardless of any particular care plan.”

“Decisions around end of life care are made in collaboration with the patient, their relatives or carer and a multidisciplinary team of healthcare professionals including senior clinicians.”

“We have a dedicated Palliative Care Team and a successful partnership with the local Prospect Hospice who support staff in providing end of life care.”

A partnership for palliative care referrals...

Their responses are all off pat

...and unconvincing, but they have taken legal advice!

More Care, Less Pathway...

Something is missing. Something has been overlooked. There is no mention of those who were consigned on this Pathway who were not dying!

This is not euthanasia, this is murder. This is business as usual.

This is Cambridge News –

Dr Keith McNeil, the hospital’s chief executive, said: “I want to reassure the public that this patient is safe, and is receiving the best possible care here at Addenbrooke’s. She is a very elderly and vulnerable patient, and the nurses and doctors looking after her have her best interests at the heart of the care we are providing.

“At all times our priority is the safety and care of our patients and all the decisions that we take are driven by this fundamental principle. The member of the public raising these concerns is not next of kin, and is not involved in the care of the patient.”

The Liverpool Care Pathway – an end-of-life plan which sees treatment, food and water withdrawn from some sedated patients – faces the axe.

Experts say the regime should be phased out over the next six to 12 months and be replaced with a personalised end-of-life care plan for each individual patient.

The review was commissioned last year and backed by Health Secretary Jeremy Hunt.

There have been suggestions hospitals might be employing the method to cut costs and save bed spaces.

The review of the pathway, chaired by Baroness Julia Neuberger, has heard evidence from patients, families and health professionals.

Further Reading -

Liverpool Care Pathway - The Six Million Dollar Plan

Liverpool Care Pathway - For The Not Dying Patient

Liverpool Care Pathway - Damage Limitation