Monday, 15 July 2013

Liverpool Care Pathway - So What's The News?

We don't need a plan; we just need care. And we need people who care to do that care. It's the doctor, the nurse, treating the patient in front of them.

Here it is, at long last, the published findings of the Review into how the LCP is used in practice.
The Telegraph
So was the one intended to bury the other...

Hunt has previously mentioned this horror that might make Mid Staffs pale into insignificance.

He chooses the day before the review report is due to be published to release this to the press. And they have had a field day because, quite simply, 'horror' is hardly a word that goes anywhere near describing this medical holocaust...

1,400 excess deaths at Mid Staffs...

1,600 excess deaths at Basildon and Thurrock...

United Lincolnshire plus The Dudley Group plus George Eliot plus Northern Lincolnshire and Goole plus Tameside plus Sherwood Forest plus Colchester plus Medway plus Burton plus North Cumbria plus East Lancashire plus Buckinghamshire Healthcare equals 13,000 needless deaths since 2005...

Or was the intention to reduce the impact of both?

The actual report is to be published tomorrow, the day after the day before. The PR people have been busily stage-managing this for some time. They knew what was coming.

Is nobody to be held to account, is nobody to be disciplined?

"Excess deaths". Mostly, they don't bother to do the paperwork on the LCP. Trusts have admitted they have no information. If they did the paperwork, or just did it properly, they would know. They don't know.

How many of those "excess deaths" are down to implementing the LCP?

Healthcare Analysis & Forecasting (HCAF)
"Excess deaths".

This paper documents a recurring series of infectious-like outbreaks -

Excess deaths are mainly for those aged 85+ although the effect can be discerned above age 65, more amongst the female than the male population.

The increase in deaths is associated with a parallel increase in emergency admissions and emergency department attendances.

The paper identifies this increase in emergency admissions, the infectious-like outbreak and, therefore, the deaths as coincident and not coincidental. It is a natural linkage to make.

a) Infectious outbreak à b) Emergency admission à c) Excess deaths

However, it is worth proposing that, whilst a) may result in outcome b), it might be that c) may result from b) and not a).

In other words, the excess deaths are resulting from the emergency admission and not the infection.

The age-group fits. An out of hours admission. An A&E department under pressure. Patient written off. Candidate for LCP. How often it happens that way...

"Excess deaths".

- Mail Online
The big brands are all swift with their responses.

The NHS. We Are Macmillan.

Macmillan already have under way a 're-brand' of supportive EoLC in Liverpool.

Mail Online
The STARS project operates a computer template added to all GP systems in Liverpool.

The Pathway is dead, long live the Pathway. And the rest.

So what's the news...?

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