Friday, 3 April 2015

Liverpool Care Pathway - Just Ticking The Boxes

It's a NICE turn of events when the QOF is more important than the cough...

Did anyone ask the punters?

Is this a case of the Monitor demonstrating it is adequately monitoring by chasing the ‘box-ticking’...?

This is Pulse –

Dr Khan said: ‘I am disappointed by the decision of the tribunal, but I am grateful that it acknowledged my practice had run for 33 years, “without incident” and with very few complaints. I have been with the NHS for 45 years.
‘This is after all a decision by the CQC based largely on issues such as the keeping of records, fire risk assessments, extension cables and hypothetical scenarios. The decision to close my surgery did not relate to any actual treatment of my patients, for which no criticism has ever been made by either the GMC or the CQC.’
He added: ‘Those who have lost most are my patients who have been forced, against their will, to find alternative surgeries to care for them, breaking the doctor/patient relationship which was in many cases, over 30 years old.’

Back in the day, family doctors knew their ‘manner’ was as important as their medicine and the patient was not an island in isolation but a part of a family unit that had consequences and outcomes.

Back in the day, there was always an appointment at the desk and the receptionist was a facilitator to get you the appointment, not a wall you had to go through to get one.

The good doctor was shut down not because he failed his patients but because he failed his QI.

It's election time come round again and the politicians are anxiously making promises which others will have to keep. Dr. Sarah Wollaston, House of Commons Health Committee Chair, comments in Pulse –
‘It’s easy for politicians to introduce these kinds of targets and directives without remembering there are unintended consequences’
Yes, there are always consequences...

GPs are resolutely fishing for their 1% but there is no ‘patient safety’ concern at the potential for the misdiagnosis of dying.

A medical holocaust has proceeded and there is no thought for the consequences or outcomes.

It’s not the cough that carries you off but the QOF may size you up for the coffin...

Accreditation, accreditation, accreditation is the one and only driving factor to demonstrate patient safety.

The devil is always in the detail but, in ticking off the detail, do you overlook the bigger picture?

Fifteen years it is and yet a further investigation begins...

Portsmouth News
A police investigation was held into the deaths of 92 patients at the Gosport War Memorial between 1988  and 2000 but no criminal prosecutions were ever brought. A review into the deaths was 10 years in the making.

They connived to release that review, the Baker Report, buried underneath the hype of the publication of the flawed LCP Review and the weekend news. Did anyone really notice?

The Barton legacy lives on.

The Wessex Guidelines became the LCP. The Barton Method became the Surprise Question and installed as part of the Gold Standards Framework (GSF). The GSF is employed by GPs to determine their 1%.

In December, the Gosport Independent Panel sat, chaired by Bishop James Jones.

Gosport Independent Panel
The Gosport Independent Panel has been set up to address concerns raised by families over a number of years about the initial care of their relatives in Gosport War Memorial Hospital and the subsequent investigations into their deaths. The Panel will oversee the maximum possible public disclosure of all relevant documentary information.
The maximum possible disclosure...

Pertinent reading -
Liverpool Care Pathway - Ten Years In The Waiting  
The maximum possible disclosure?

Why not full disclosure? What is there to hide? People have died before their time. Their lives were taken. After 15 years, isn't it time to tell the truth?

Was it all a testing ground for what has happened since? A programme has been rolled out which continues to this day. Lives have been taken. They have died before their time.

Where are the missing 90-year-olds? Were the projections wrong...?

BBC News
“ Sadly, they've already died. They just didn't live as long as statisticians had predicted.
Thousands of elderly people are missing. The last UK census found far fewer people in their 90s than expected, and the same thing happened in the US with people over 100. Could this be an early sign that gains in life expectancy made in recent decades will not be repeated in future?
There were 30,000 fewer people aged in their 90s than were projected should be the case...

A programme has been rolled out. GPs are sizing up the usual suspects for their 1%.

They can eye you up and by intuitive assessment 'know' you are going to die. That is the essence of the GSF Surprise Question; that is the Barton Method. They interpret that nuance of tone, that expression. We have come a long way.

Lives have been cut short. That is murder.

The Gosport Independent Panel is now joined by Dr. Bill Kirkup.

Dr. Kirkup has been chairing an inquiry into infant deaths at Morcambe Bay and now joins the inquiry into elder deaths at Gosport.

This is the North-West Evening Mail reporting on the Barrow Hospital Inquiry –

THE chairman of the inquiry into poor maternity care and deaths in Barrow’s Furness General Hospital has said he was “disappointed” by the response of professional bodies to his report.

Dr Bill Kirkup, who lead the investigation into University Hospitals of Morecambe Bay Foundation Trust has said he wanted to see more “professional leadership” from bodies such as the Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives.

Dr Kirkup told the Health Service Journal: “I am disappointed that there wasn’t a stronger response from the professions, particularly the medical profession. There just hasn’t been any attention given to it at all."
There have been "avoidable deaths". Lives have been lost and lives have been taken.

In anyone's language, morally, that is murder; at the very least, it is manslaughter.

And the good doctor is shut down, not because he failed his patients, but because he failed his QI...

It's a NICE turn of events when the QOF is more important than the cough.

Further reading -
Liverpool Care Pathway – 'The End Of The Line'

Liverpool Care Pathway - The Three Options: A Post-modern Fairytale

Liverpool Care Pathway - Twenty Four

Liverpool Care Pathway - There Are Always Consequences

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