Monday, 18 November 2013

Liverpool Care Pathway - Lamb's Gambit And Check

When you got the moves, you can plan the strategy ahead...

A £2 million black-ops cover-up kitty…

Here's the Birmingham Mail –
12 Jun 2013 - MP Stephen Barclay accused Sir David of being complicit in a “systemic cover-up” after figures showed £2million had been paid to stop NHS staff from speaking out.
When this man reaches his GSF end of days, he will not be winding down his health options; his priority will be to seek all the medical help his substantial public pension may muster to prolong his survival. As they do.

This man should be stripped of his title; it dishonours the monarch who granted it to him. This man should be stripped of his substantial public pension and made to live in the penury which countless pensioners are forced to live in.

Having served out their working lives and paid their dues (and now looked upon as a drain on that very public purse to which they have contributed throughout their working lives) they are sized up as candidates for the Death Lists.

On this man's watch, a scandal of criminal proportion has proceeded. "Grave failings" have been admitted. An unfortunate choice of words, but what matters it? It is only our old ones who have been put down and they’ve had their innings and it's time to wind them down for EoLC anyway!

Why does the DoH cover up this man’s sins other than because the DoH has been complicit in them? 

This man has lied and lied and lied. If he has not lied, then he is surely incompetent. Which is it? Whichever way it is, he should not be rewarded for it. This is public money. This is OUR money!

The £2 million kitty is become a £4 million kitty…

This is The Telegraph
15 Sep 2013 - NHS 'covered up' £4m of gag orders.

The head of the NHS has been accused of a “systemic cover-up” after official figures disclosed that hospitals have spent more than £4 million on secret gagging orders.

It is implausible deniability. How could he not have known any less than Mr. Lamb and Mr. Hunt could not have known about the LCP CQUIN payments?

This was information in the public domain and knowledge to which they were privy.

This from these pages -



The Department of Health (DOH) uses a Commissioning for Quality and Innovation (CQUIN) payment framework which enables commissioners to reward excellence by linking a proportion of providers’ income to the achievement of local quality improvement goals:
"It makes a small proportion of provider income (0.5% of contract value in 2009/10) conditional on achievement of locally agreed goals around quality improvement and innovation. It is intended that goals should be stretching but realistic."
CQUIN has set targets for 2011/2012 with regard to the End of Life program.

The forward plan is to increase the number of patients identified to be on the end of life care pathway and from a baseline of 0% to 20%; it is further planned to have 30% of all patients who die in hospital dying on the Liverpool Care Pathway.

To ensure they receive their provider income in fulll, Trusts have to comply with or exceed these goals. Some, like Royal Brompton, have upped the plan expectations:

1) 95% of patients identified as end of life (last 48 hours of life for expected deaths) are offered an EOL care planning discussion
2) 80% of patients offered a discussion should have an advanced care plan
3) 98% of patients who have an advanced care plan should have a record of the decision to resuscitate stated clearly in the notes
4) 50% of patients who die in hospital (expected deaths) should die on a Liverpool care pathway 
It is the DOH which is the driving force behind rolling out  LCP across the NHS!

Are we governed by incompetents or governed by liars?

These incompetents or liars, whichever way it is, have cleverly jettisoned the fuel tanks to make it appear they are sunk. Not at all.

When is a review not a review? When it is a cover-up. They have surrendered a position for ulterior purpose. It's the Bobby Fischer "Game of the Century" all over again. They have sacrificed their Queen to gain battle advantage and win the game.

The chess world had its 'game of the century', played out at the Rosenwald Memorial; the medical world, of course, had its 'shame of the century', played out at the Gosport Memorial!

Studies have shown that early discussions on EoLC are advantageous in downsizing care expectations and eliminating expensive hospital admissions.

The Nudge Team have demonstrated that it is possible to send coals to Newcastle and icebergs to Eskimos.

It's a no-brainer and doesn't require a Macmillan survey of bereaved relatives and carers to determine this to be so: that most people would prefer to die in their own homes, in their own beds, with their loved ones around them.

That doesn't mean they want to die just yet, though, or anytime soon. Most people do want to live and want everything possible to be done to keep their options open and to seek second opinions.

Cleverly worded that the right to die at home is being denied arouses a clamour and demand for this wrong to be righted.

I don't need to try to swoon you
Listen to my words and I'll groom you

With them moves like Fischer
I've got the moves like Fischer
I've got the moves like Fischer
[Apologies to Maroon 5]
They're winding them down...

This is GP Online

Starting discussions

Dr Foster said: 'For patients, it means they can predict things a little bit more, a little less reactively, and more proactively. They get early involvement with Macmillan nurses, for instance.
The shift to palliative care...
Coastal Medical Group is one of only nine practices that have achieved accreditation since it launched in 2012.

Dr Foster, who leads the practice's palliative work, said working towards the accreditation led to a five-fold increase in the number of the practice's patients on the palliative care register when they died.

Twice as many carers have had their needs assessed, while the number offered bereavement support and advice has risen from 5% to 77%.
The GP report continues -
Nationally, about 51% of people die in hospital, despite most people wanting to die at home.
It ain't what you say, it's the way that you say it. Most people want to live. If they have ended their lives in hospital, it has been in the pursuit of curative options to continue their lives - or because their lives have been ended...

Here is the Bournemouth Daily Echo –
DOCTORS at The Royal Bournemouth Hospital have been accused of “signing a death warrant” after issuing an order that allowed a dementia patient to die if she became seriously ill.
June Brook, 79, was being treated for sickness and diarrhoea, but during her stay doctors, signed a “do not resuscitate” order without informing the family.
The order, which states the family were "not available", was found in Mrs Brook's bag after she was discharged.
Two doctors signed the order, which stays on a patient's records, stating that CPR would be inappropriate because Mrs Brook has dementia.
So, dementia, as well as old age, is now good cause to let them go.

2013, the year of the Snake, whispers and secrets; 2013, the year of the dementia CQUIN.

Kevin Brook has called the DNACPR a death warrant. His mother is grateful to be alive.

The only justice to be had for those left behind following the Mid Staffs debacle is a pay out to pay them off. As if money can compensate for what has been done...

But they are robbed even of that!

This scandal also proceeded on David Nicholson's watch.

This is the Mail Online
Bereaved relatives and victims of the Mid Staffs scandal have been frustrated at how long their legal cases have taken.
By the time some cases finished, the medical staff responsible for the blunders had retired or changed careers – sparing them any accountability.
Julie Bailey, who set up the Cure the NHS campaign after her mother Bella died at Mid Staffordshire, said: ‘If the NHS stopped harming patients then the solicitors wouldn’t be able to claim the money.
‘The NHS has created this situation by harming patients and then making it so difficult to get answers.
'If you take legal action you just get a small settlement. You don’t learn any answers and the trust doesn’t learn any lessons.
'I have met people who have been in a legal battle with the NHS for 20 years and they still have no answers.’
Deb Hazeldine, whose 67-year-old mother Ellen Linstead died at Stafford Hospital, added: ‘The system is torture. It took me three years to get my complaint upheld. They treated my complaint with utter contempt.
‘My mum died of something she caught in hospital. The responsibility is on the trust to be open and transparent.’
Lawyers say they expect to see an ‘explosion’ in medical negligence claims in future years, following the scandals at Mid Staffs and at Colchester Hospital University Foundation Trust this week.
Last year legal firms received £250million through claims against the NHS as a whole for medical negligence.
During a 12-month period between 2011 and 2012, five practices received £35million between them.
The scandal is that those who should pay are not being made to pay for what they have done.

Nicholson has had his payoff. There is no justice, either done or seen to be done.

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