Liverpool Care Pathway - Hot On The Scent For Their One Per Cent!

The EoLC posse is out on the scout to rope in the usual suspects.

This is the South Warwickshire CCG Commissioning Intentions 2014/2015 –

In collaboration with social care we will start a process in October 2013, to procure support tailored to residential homes. We aim to have a new service in place by 1st April 2014. We want to improve the quality of End of Life (EoL) services for our population. On the basis that each year 1% of our population dies, we want our end of life registers to reflect this. By March 2016 we want 0.8% of our population on an End of Life Register. Significant work is being undertaken by our member practices and by the end of 2013/14 we will be implementing the following initiatives to improve EOL services: • Gold Standards Framework Primary Care Training Programme;• Electronic Palliative Care Co-ordination System (EPaCCs);• The Route to Success in End of Life Care in our 26 nursing homes;• End of Life best practice tools in primary care and nursing homes and;• We will have awarded and mobilised a contract for a practicedevelopment team. By November 2013 we will have commissioned an Admission Avoidance Programme (Phase 1) to keep people at home. This willprovide patients with access to specialist opinion and/or diagnosticswithin 24-48 hours for patients. In November 2013 we will start the more comprehensive Admission Avoidance Programme (Phase 2). This will impact on services outsideof the hospital and is anticipated to significantly change the number andtype of contracts we have with providers from April 2015.

"...On the basis that each year 1% of our population dies, we want our end of life registers to reflect this. By March 2016 we want 0.8% of our population on an End of Life Register" (irrespective of whether these 0.8% selected for the Death Lists are actually part of the actual statistical cohort or not!).

Our major focus in 2013/14 has been the progression of the Discharge to Assess service. 

In commissioning for health and social care outcomes we will beseeking to undertake competitive processes. The joint engagementwork and development of our first draft of the TransformationIntegration Fund will indicate the areas where we are seeking toimplement this approach. However, from existing work we haveidentified the following areas for 2014/15: 

• Admission Avoidance Programme (Phase 2) (Includes Out of Hours
(OoH));• Discharge to Assess;
• Support to Residential Homes

Discharge to Assess is the brainchild of Professor Ian Philp, Medical Director at South Warwickshire NHS. Philp is well-established in EoLC. Philp was the so-called Geriatric Tsar from 2000 to 2008. The focus of concern was always the numbers.

The priorities always top the list and this sits right at the top of Philp's archived document -

Older People’s Care in Numbers 

People over 65 make up around 16% of the population but this group:1. In 2003/04 accounted for 43% (£16.47bn) of the NHS’ total budget.2. Occupy 65% of acute hospital beds.3. In 2005/06 accounted for 63% (5.02 million) of all finished consultant episodes in acute hospitals.4. In 2004/05 accounted for 58% (£6.38 bn net) of social services’ budgets.5. In 2004/05 received 71% (1.23 million people) of social care packages. 

- A Recipe for Care

It is logical that greater need does translate through as greater cost. That is not to say care - real care - cannot translate through in the more logical application of care in order to cut cost whilst maintaining and improving care provision. However, whatever Philp's intention, this is not at all what has translated through.

Philp has taken the view that the demise of the Liverpool Care Pathway is a 'tragedy' and is equivalent to banning the Highway Code because of bad drivers. Does he, then, support and is he actively promoting the prosecution of those 'bad drivers', drivers being the operative word, perhaps? Will he act with immediate determination, for instance, to get Dr. Alison Coackley removed from the Medical Register and seek a charge of murder - at the very least, manslaughter - against her?

Read further here -

Liverpool Care Pathway - These Disgusting People

Liverpool Care Pathway - Onward And Upward

Of course, we know, and I am sure Prof. Philp knows, that the LCP scions live on and are multitudinous...

Philp shows his human side in a Telegraph article where he relates having to "struggle with the system" when his elderly mum is taken into hospital following a fire. That is in 2002. A lot has changed since then.

Philp has become well-established in EoLC and part of the DoH EoL Strategy.

"The NHS End of Life Care (EoLC) Programme is part of an overall strategy to give people greater choice in their place of care and death and to provide training for health and social care staff to help care for people at the end of their lives.

It aims to reduce the number of emergency admissions to acute care for those who wish to die at home and reduce the number of patients transferred from care homes to acute care in the last week of their life."

Professor Mike Richards, National Director for Cancer

Professor Ian Philp, National Director for Older People

NHS End of Life Care Programme Progress Report March 2006

NHS EoLC Programme Progress Report March 2006

The South Warwickshire Commissioners are intent. "...On the basis that each year 1% of our population dies, we want our end of life registers to reflect this. By March 2016 we want 0.8% of our population on an End of Life Register" (irrespective of whether these 0.8% selected for the Death Lists are actually part of the actual statistical cohort or not!).

The RCGP (Royal College of General Practitioners) has lined up with Marie Curie to facilitate this end –

Proposed outcomes of the programme include:

• new clinical guidelines for GPs and primary care teams

• online tool kits and support for healthcare professionals

• promotion of primary care training in the area of EOLC

• identification of local and national developments in EOLC to shape RCGP policy

• influence and support for clinical commissioning groups in EOLC planning

The programme will be led by Dr Peter Nightingale, who was appointed joint RCGP and Marie Curie Clinical Lead for End of Life Care earlier this year.

Nightingale has the expertise and force of Macmillan behind him (or with him), of course.

Our GPs will be eyeballing their flock eagerly to spy out their batch to make the stats fit the numbers and, who knows, actually exceed them! And they now have the experts to assist them in this.

This is excellent news and will go far toward securing the NHS "now and for future generations".