Monday, 28 October 2013

Liverpool Care Pathway - There's Life In The Old Dog Yet

How to cut social spending without cutting social spending: that is the question. By limiting life expectation...

Europe is staggering beneath debt and will stumble and fall into the bottomless pensions black hole. Unless...

There is the Merkel option of creating vassal states...

There is the Obama option of raising the debt ceiling...

The remedy is there and in place. And soon to be in place (Obamacare).

The LCP is dead; long live the LCP...

The Palliativ Portal reports on the outcome of the Review in the UK but says that the LCP should continue to play a primary role in Germany. All current implementation of the LCP can continue.
Palliativ Portal
The University Hospital of Cologne summarizes their reaction to the results in three points: The LCP can and should be first in Germany to be used as is on. All ongoing implementation projects can proceed. The current registration process remains unchanged. In the further development of the essential contents of the LCP, as the communication about dying and the design of the treatment plan, and a comprehensive training program will continue to be the focus. 

Therefore, the basic principles of the LCP will be retained in the further development towards an "end-of-life-care plan."

The Basic principles of the LCP will be retained. The Zentrum für Palliativmedizin is the coordinating body for the LCP and, together with Deutschen Gesellschaft für Palliativmedizin (DGP), will continue to actively promote the application of the LCP in Germany and in international development.

This is Uniklinik Köln – 

Updates to LCP
Here you will find current information from the LCP Coordination Office
Meeting 2014 German-language working group
The German working group on the LCP meets on 03.04.2014 in Heidelberg . All registered facilities will be contacted in due time.
Updates to LCP in England
The concept of the LCP is being fully revised in the Marie Curie Palliative Care Institute Liverpool (MCPCIL). This will have an impact on the further development of the LCP in Germany. In an international meeting on the LCP on 26/11/2013 in Liverpool, where we will participate as coordinator in Germany, these changes are discussed and specified. We will promptly inform about the results and the consequences for the LCP in Germany.
The Review in the UK has passed judgement. Has the LCP had its day? Perhaps not...

The Wirral End of Life Care Plan is only a revamping and re-branding of it.

The Control Record actually says –

"Change of name from Liverpool Care of Dying Pathway to Wirral End of Life Care Plan as instructed".

The international LCP Big Guns are meeting up on the 26th November in Liverpool. Don't think it's all done and dusted, cos it ain't!


The MCPCIL in its October 2013 News Release is as selective as ever in what it reports and what it does not report.

This is MCPCIL
October 2013 MCPCIL Statement in response to the publication of Randomised Control Trial of the LCP-I (LCP-Italy)
This landmark study supports the finding of the Neuberger Review in to the Liverpool Care Pathway that where implemented well the LCP can support the provision of good quality care for dying patients.
It is encouraging that a small improvement is seen in overall care for patients cared for in wards where the LCP is used compared with wards where it is not.

The study reported in Medscape found that the LCP actually offers little clinical benefit.

However, lead author of the study, Dr. Massimo Costantini, stated that the LCP does have the potential to close the gap between hospice care and hospital care.

And in Sage Journals -
Conclusions: These results provide the first robust data collected from family members of a preliminary clinically significant improvement, in some aspects, of quality of care after the implementation of the Italian version of Liverpool Care Pathway programme. The poor effect for symptom control suggests areas for further innovation and development.Sage Journals' Palliative Medicine
This actually confirms an earlier Study reported here -
Liverpool Care Pathway - A Cover For Euthanasia...?
This also recorded poor effect for symptom control...
In a before-and-after pilot study conducted on 4 hospital wards, the LCP produced improvements on measures of respect, kindness, and dignity, family emotional support, self-efficacy of the family, and coordination of care.
However, it did not improve symptoms of pain, breathlessness, or nausea and vomiting.
The results were published online May 7 in Palliative Medicine.

No worries. They'll get their act together for the LCP Summit in November.

There may be life in the old dog yet.

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