Saturday, 13 July 2013

Liverpool Care Pathway - Hot Off The Press

So is the Death Pathway a death pathway or is the Death Pathway not a death pathway?

The government review is shortly to publish its findings.  Mail Online was fed, or obtained, a pre-release of these findings which it published last week.

This week, more slips out and the story's taken up by other publications. There's not much consistency. It's all pretty much of a hotch-potch. So, what's going on?

Are they testing the ground? Denise Charlesworth-Smith should be able to tell us, but it's likely she won't be privy to what's going on in the inner circles and they'll be buttering her up with some plum job or other. 

The Telegraph falls for the Goebbels factor and repeats an oft-repeated lie, but gives it a new twist:
The principle of national guidelines is strongly supported by doctors. A survey this year found that nine in 10 who used the pathway thought it represented “best practice”.
Dr.Peter Saunders, appearing on Everyday Ethics,  actually misrepresented the facts of the BMJ survey for Dispatches even further, and so forthrightly did he speak and with such authority that no-one dared to question him:
"Ninety-eight percent  of over 3000 doctors who were surveyed for the British medical journal in the last week...Ninety-eight percent said that, if appropriately used, it can help people to die much more comfortably."
This BMJ article asked -
The Liverpool care pathway: what do specialists think?
It must be said, a marvellous array of graphs were provided to give, well... a graphical illustration of the results.

The feature mentioned that, of 3021 UK hospital doctors emailed for an anonymous online survey of their views on the Liverpool Care Pathway, only 647 responded. That's only 21.4% of the 'over 3000' doctors.

Only 90% of this 21.4% responded favourably. That being the case, that nine out of ten 90% doesn't look nearly so good... And it's certainly not 98% of the 3021!

Who are these 3021 doctors, in any case? Why were they singled out for the survey? There were, apparently, some 231,000 doctors on the Medical Register as at 2010.

And what's this all about?

The LCP is going to be 'phased out'.

The review, apparently, found 'shocking' examples of abuse across the NHS.

Shocking examples of abuse! And they are going to 'phase it out'? Shouldn't it be scrapped with immediate effect before any more damage is done? What's going on?

Is the Death Pathway a death pathway or is the Death Pathway not a death pathway?

Norman Lamb is pictured grinning from the pages of Mail Online, but this is no laughing matter. What of the other death pathways?

The Welsh Collaborative Care Pathway had a 'fundamental rewrite' and was relaunched because of 'adverse publicity'. Now, the same is happening to the LCP.

The Dignity Care Pathway utilises psychometrics with the PDI (Patient Dignity Inventory).

The DCP "was acceptable to the community nurses, helped them identify when patients were at the end of life..." [Evaluation of the Dignity Care Pathway for community nurses caring for people at the end of life.] 

"Nurses identified that using the DCP allowed them to reconsider which patients required palliative care. In line with Scottish Government (Scottish Government 2008) policy, this study encouraged nurses to consider approaching any patient who the nurse considered was in the last months of their illness, regardless of diagnosis, and including the frail elderly."
[PAGE 12 - QNIS Project Report]

"The community nurse makes a prognostic, clinical judgment to decide when to start a patient on the DCP..." [Dignity in End-of-Life Care]

The Pathway, clearly, is a multi-headed Hydra that, whatever the review actually says or doesn't say, is determined to outlive us all.

And there are others. The GSF, the Amber...

What of the GPs and their one percent?

The King is dead, long live the King. This is monstrous. This is a con.

The CQUINs are in place. They continue.

And there are those who continue in office.

This is what the man with the quicksilver tongue, the honourable Earl Howe, remarked in regard to the cries from the wilderness in regard to this awful Pathway -


"... there may be less substance to some of these stories than may first reach the eye."

"they are anecdotal and without substance."

Disgraceful! Absolutely disgraceful! If they won't resign, then sack them all!

Is the Death Pathway a death pathway or is the Death Pathway not a death pathway?

What will the Review actually say? At present, we only know what has been fed to the press. Watch this space.

Further Reading -

Liverpool Care Pathway - Who Monitors The Monitors And The Monitors Of Monitors...?

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