Thursday, 7 November 2013

Liverpool Care Pathway - The Bee Wee Protocol

There have been deaths as a result of admitted catastrophic failures in implementation of training. Is no-one responsible and to be held to account?

Everyone has been moving ahead with their own 'Designs for Death'. Using the Trotskyist tactic, the Bee Wee Alliance now assumes charge.

This is NHS England 

Following publication of the Review, a so-called Leadership Alliance was set up with Dr. Bee Wee as acting Chair. The member organisations of this Alliance all gave unfailing, uncritical support of the discredited LCP.

The member organisations of this Alliance all acted under or were associated with the NCPC EoLC umbrella; all were thoroughly dismissive of every and any criticism of and allegation made against the Death Pathway.

There are no independent persons or organisations in this Alliance. It is almost as if they have been found out and are closing ranks. They are all tarred with the same brush.

The prior 2012 versions permitted them to act without consent. That is manslaughter.

Supporters and apologists dismissed as anecdote and hearsay that lives have been cut short, that those not 'dying' have been condemned to death. Abuse and wrong-doing have been compounded by abuse and wrong-doing.

The Review highlighted failures in training. Both the Review and Dr. Bee Wee have blamed the failures in training for the catastrophic failures in implementation of the Death Pathway. Dr. Bee Wee was responsible for this disastrous training.

Dr. Bee Wee, acting chair Leadership Alliance, President of the Association for Palliative Medicine of Great Britain and Ireland and a Consultant/Senior Lecturer in Palliative Medicine at Oxford University Hospitals NHS Trust and the University of Oxford, was National Clinical Lead responsible for e-training in the Liverpool Care Pathway.

Whether it is the Pathway or the training, is someone not to be held to account? Is Dr. Bee Wee not to be held to account? People have died!

This is the Engagement Document – 

Ring out the old:

A diagnosis of 'dying' is made. LCP is implemented.

Ring in the new:

A. People who have a progressive, life-limiting illness have been offered the opportunity to develop, document, review and update a personalised palliative care plan at different stages in their illness or condition.

Palliative care sets out to relieve the symptoms of a condition, not to cure a condition. Care is downsized.

Ring out the old:

Patients should be supported by the LCP when they are in their last days or hours of life and there is no treatment available that will reverse their condition.

It can be difficult to tell how long someone has left to live. The LCP recommends that doctors and nurses regularly assess a patient. Some patients will improve, and then the use of the LCP to guide their care will stop.

Ring in the new:

B. People, including those thought to be in their last days of life, whose condition changes, are identified in a timely way, receive good care that is reassessed at least daily (or more frequently as their condition requires), receive timely appropriate medication and have their emotional, psychological, social and spiritual needs addressed.

The net is trawled wider. "People, including [as well as] those thought to be in their last days..."

Addressing of "social and spiritual needs". The same 'Holism' of the Death Pathway.

The Document continues:

C. Regular, pro-active and responsive communication takes place between professionals and the person who is approaching the last days of their life and their family and carer. The content and outcomes of these discussions are clearly documented and shared with others involved in this person’s care.

D. There are arrangements in place, with which the individual is in agreement, to share key information about his/her care, treatment and preferences between professionals, service providers and others relevant to the person’s care.

E. Local governance arrangements are explicit about the role of ‘senior responsible clinicians’, delegation arrangements when the person’s usual GP or consultant is not on duty, information sharing arrangements to enable timely decision-making, and how people who are approaching their last days of life, and their families and carers know who are their ‘senior responsible clinician’ and nurse responsible for leading their nursing care.

This is all rolled out or being rolled out already with the local registers or Death Lists with such beneficent names as "My Wishes".

F. People who are approaching their last days of life, and their families and carers, receive the benefit of specialist palliative care (see glossary – Annex B) advice and support in a timely manner.

G. Families and carers feel supported, including knowing how to seek urgent help when this is needed for the dying person whatever time of day or night, and having their own needs addressed or signposted to sources of help and support.

Here, NHS Scotland may well be steaming ahead, hoisting some extra sail in the rigging...

Ten years before the mast!

All the more reason for the Bee Wee Alliance to step in and take charge.

This is Airedale NHS

This is the hotline to hel(p) for those in their last year of life.

Wow, they're so good at diagnosis and prognosis now, aren't they?

Dr. Barton 'knew' her patient, Mrs. Richards, was dying just by looking at her.

Now, using this same Barton Method, your doctor can look at you and 'know' you're going to die within the next 12 months. Medicine is advancing by leaps and bounds! Care can be downsized to palliative much sooner and huge savings made in the stretched and straining, bulging NHS budgets, thus securing the service "now and for future generations".

The Document, further, asks:

Questions for engagement/feedback:
4. If you agree with the proposal to offer a personalised palliative care plan, do you agree with calling it a ‘Personal Palliative Care Plan’?
If not, what should it be called?

A Sunstein Nudge in the right direction is being proposed.

5. If personalised palliative care plans are to be introduced, it raises a question of how and where this should be kept. If it is kept in the person’s home, he/she would be able to look after it more easily. However, it may delay the ability of health and social care professionals (such as a doctor, nurse or ambulance staff) to take appropriate action on behalf of the person if the professional is not able to easily get hold of the information when needed. Do you have any ideas for how to find an answer to this practical question?

These 'personalised' plans are in place. Care is being 'coordinated'. They will all clamour to the Bee Wee Alliance and Bee Wee will take charge...

A true master of the Tactic. Congratulations Comrade.

Chairman Ellershaw...?

Additional reading -
Liverpool Care Pathway - The Dust Has Settled. All Change! Nothing's Changed.

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