Saturday, 31 August 2013

Liverpool Care Pathway - Carry On Up The Pathway

When is the Liverpool Care Pathway not the Liverpool Care Pathway?
When it's the Liverpool Care Pathway...?

This is on Palliative drugs forum -

Liverpool Care Pathway
Posted by: Mrs Sarah Charlesworth (IP Logged)
Date: August 12, 2013 10:28AM

Many thanks go to Dr Saskie Dorman (Poole Hospital NHS Trust, UK) for sending us their Personalised Care Plan for the last days of life, an interim set of documents incorporating and building on the principles of good care outlined in the Liverpool Care Pathway, which has been discontinued in their NHS Trust. Comments or suggestions for improvement have been requested. 

We have added these 4 documents to the document library under the topic of End of Life Care (palliative care pathways). We would like to encourage members to donate more documents on this subject (with the author’s permission), for the benefit of all our members. Please send them to us at In addition, if you are a UK health professional, please complete this month’s survey ‘Liverpool Care Pathway- What are you doing?’

Just change the logo and the headed notepaper...

For all intents and purposes this is the Liverpool Care Pathway documentation.

NHS Lanarkshire
This is the NHS Lancashire Liverpool Care Pathway (Hospital Version) -

Patient awareness of dying; religious/spiritual needs assessed...
Ongoing assessment of symptoms

 - Nursing Care Plan

This is the Poole Hospital NHS Foundation Trust Personalised Care Plan for the Last Days of Life -

Patient recognition of dying; religion and spirituality needs assessed...
symptom management consideration

There is also a Community Version and a Care Home Version of this LCP document.

The Poole document is in four parts -

This is the same tick box Pathway, Mr. Lamb. Seems like 'Change the Name' is the name of the game. Switch branding and carry on as before. Same train, different livery. It's still Murder on the Death Pathway Express. 

On the front of the document there is a reminder to apply the principles of the Mental Capacity Act 2005. But you don't have to ask the patients' consent if you feel a discussion will be too distressing for them. Oh, well… Acting in the patient’s best interests and all that.

Advice is given that patients who are thought to be dying should usually be prescribed medication for the relief of pain, nausea, vomiting, restlessness and respiratory tract secretions, unless there are contraindications.

No mention is made as to what to do if there are contraindications, however...

Advice is given to "Stop investigations, interventions or treatments that won’t promote comfort, dignity and peace".

You don't know if you don't try. Never mind, just give up and tick that box, job done!

The three LCP documents each include a space for a named Macmillan Nurse. Macmillan and Marie Curie must also answer to the medical holocaust that has proceeded.

Mail Online
And according to a survey reported today, a third of cancer patients do not trust the nurses treating them.

The Brand is all and what brands they are! All that and still come through it looking squeaky clean...

"It is myself I mean, in whom I know
    All the particulars of vice so grafted
    That, when they shall be opened, black Macbeth
Will seem as pure as snow..."
Act 4, Scene 3, Page 3

Advice on clinical management - Edited by the Wessex Palliative Physicians

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