Sunday, 8 September 2013

Liverpool Care Pathway - A Right Carry On Up The Pathway

On the day the Review spilled the beans on the Pathway, at Sandwell and West Birmingham they were holding an Event...for the Pathway!

Across the generations

BBC News Health
Kathleen Vine - All I can remember is they weren't feeding me. Up above my bed, they'd put 'Nil by Mouth' and I was begging for food.

Helen Grady - Can you remember when you were asking for food what happened? How did the hospital respond?

Kathleen Vine - They were ignoring me...
Liverpool Care Pathway - The Report

On the day after she'd gone onto the Liverpool Care Pathway, we were visited by an end of life nurse. And he was ever so nice - I mean, the nursing staff were all lovely - and he came in and he was sort of asking us if we'd thought about the funeral and how we were going to tell our daughters, and just, sort of, getting us to talk about it, I suppose. And I was saying, I just can't believe it. You know, she came in with a dislocated shoulder ; we're now being  told she's dying. Nanny woke up at that point. And she had a full on conversation with him. She actually flirted with him. You know, she was saying, ooh, aren't you lovely? You've got lovely eyes. Surely, that's not a dying person. She's chatting you up, asking if you'll feed her... This, this can't be right, you know. [Laugh...] - Kathleen Vine's granddaughters
Liverpool Care Pathway - The Report

A lovely "end of life nurse" who is trained in grooming counselling. Fortunately for Mrs. Vine, the drugs had taken insufficient effect. She woke, that saved her life. That "lovely end of life nurse" would have persisted with his charm until he had succeeded in grooming his subjects into planning the funeral.

Thank heaven the Review has shut down the LCP. Well, in England, at least. But not in the rest of the UK. The UK doesn't exist any more. We are just constituent states of the EU. Much less bother for Brussels/Berlin. At least doctors can kill people on the mainland when they need to.

They have shut down the LCP, haven't they?

Kathleen's case came to light because of media focus on the issue. 

Eugenie Edward's case came to light solely because of the media focus of her famous daughter, Rustie.
Rustie Lee -

The television star said that her mother was already showing signs of improvement and was able to eat by the time she was told that doctors had placed her on the pathway.

“When I saw my mum in hospital she did seem poorly, but not as if she was about to pass away,” said Lee.

“In fact, she didn't look close to that.

"Yet we were told she had 24 to 48 hours to live and was about to be put on this pathway.

“I was only told about the plan when I went over to see the nurses to ask for painkillers for my mum.

“I was so shocked to be told she was on some pathway. I told the doctor this was not going to happen.”
- Liverpool Care Pathway – Is There No End To The Tally?

These are crimes that have been committed. Have these medical criminals been taken to court or even taken to task?

Consider this: if they had succeeded in doing what they had set out to do, Kathleen and Eugenie would be dead. That would be murder.

Thankfully, they did not. Still, should not a charge of attempted murder be served upon these gangs of medical criminals, or have they truly been served with a licence to kill...?

They did not succeed in their evil work only through family intervention. How many of our old ones, alone and vulnerable at the mercy of these medical criminals, have been thus consigned to the hereafter?

Even having relatives to stand by them did not necessarily stop these medical criminals in their vile work.

Despite all the good and worthy efforts of David James' family, the medical criminals were supported in their evil designs by vile judges who think they sit in Solomon's court. But Solomon's judgements were, apparently, tempered with wisdom and mercy in choosing not to slice the babe in two!

Thank heaven the Review has shut down the LCP.

They have shut down the LCP, haven't they?

Well, no.

It carries on as before without a name. It carries on, rechristened, bright and sparkling new. It carries on because it did not bear the LCP brand...

The Pathway that nearly murdered Eugenie Edwards is the Supportive Care Pathway (SCP).

On the day the review was published, July 15th - having already got the heads-up on the grapevine - Sandwell and West Birmingham Hospitals NHS Trust held this event -

Jul 15th 2013

Learn more about the Supportive Care Pathway

Following the success of an event for Trust members on the Supportive Care Pathway last week, Sandwell and West Birmingham Hospitals (SWBH) NHS Trust is inviting the public to another event today!
Dr Anna Lock, Palliative Medicine Consultant, Kate Hall, Palliative and End of Life Clinical Service Manager and Sue Law, Bereavement/SCP Practice Development Nurse all from the Supportive Care Pathway and Palliative Care team will be offering you the opportunity to ask questions, hear from clinicians across the Trust and see an example of the Supportive Care Pathway programme.
The Supportive Care Pathway is designed to give the best possible care to patients in the last months, weeks and days of their lives. If you would like to find out the facts, come along to the Wolfson Lecture Theatre in the Post Graduate Centre at City Hospital at 7pm, today!
For details on other upcoming events from the Trust please visit:

This is the LCP SCP -

CS 0186 Supportive Care Pathway in Birmingham

11 May 2010

Key Points
  • The Pan Birmingham Cancer Network has developed an end of life care pathway for patients in one acute trust, regardless of diagnosis
  • The Supportive Care Pathway (SCP) is currently used on seven wards in Sandwell and West Birmingham Hospital NHS Trust and the trust aims to extend it to all its acute wards
  • There are plans to develop an SCP for critical care patients and a last days of life information leaflet.
The Pan Birmingham Cancer Network has developed a specially tailored end of life care pathway for all patients in acute hospitals, regardless of diagnosis.

The pathway, which is called the Supportive Care Pathway (SCP), is currently being used on seven wards across Sandwell and West Birmingham Hospital NHS Trust with 200 patients having been started on the pathway since January 2009. The trust is committed to extending its use to all its acute wards in due course.

The underlying principles of the SCP, which can be used in the last year of life, are diagnosing dying, regular holistic assessment, symptom control, rationalisation of medications and interventions, anticipatory prescribing, communication and bereavement care.

The aim is to identify dying patients promptly and improve the quality of end of life care by providing a focus on end of life issues and ensuring the multidisciplinary team is closely involved at every stage. The pathway is not prescriptive and does not curtail any care that would benefit the patient. However, because it is an end of life care pathway, it will direct the team to consider comfort measures as a priority.

The SCP sets out goals through a holistic assessment tool. Every day the team is prompted to consider rationalising interventions and medications through an individual patient-centred approach, so decisions are made either with the patient, or, if this is inappropriate, in their best interests.

Once the patient is on the pathway there are three possible outcomes. The team can decide the patient is no longer at the end of their life and the pathway can be stopped and regular documentation resumed. Alternatively, the patient can be discharged to home, hospice or nursing home. But most will stay on the pathway until they die.
Supportive Care Pathway

This is the LCP SCP -
"You say SCP, I say LCP,
Let's call the whole thing off..."
Would that we could!


The Pathway is a Hydra and, like Heracles, must we summon aid to cauterize the beast...?

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