Wednesday, 8 June 2022

Liverpool Care Pathway - The Last Post

  


The West has reached a moment of ultimate crisis at which it may already be beyond the point of no return. The doomsayers have had their say and the last post has sounded for the last time. Has the West had its day? Will we make this our Dunkirk or our D-Day...? 

Just when you think it's all over, you realise it never went away. The bans are already posted for the banquet and we are invited to be the meal.



The  soldier turns at the flagstaff to mark the phases of the day. The last post consists of all the bugle calls and is sounded at dusk to mark the days end. Shall it mark, also, the end of days?

We were only half-way there and living on a prayer. 2020 is here and gone, Devo-Next is Devo-here and we are two long years down the rabbit hole. The Union is in disunion and dismemberment. Life is in disregard and the Kingdom is torn asunder.

This 'last post' was prompted by a meme...

I don't disagree with the text of the meme but it was not that which caught my attention. It was the image; I recognised the image immediately!

The image, of course, is from a photograph of the audience watching one of those 3-D movies of the 60s which never really caught on but which became a sensation for a while.

Everyone dons the tinted glasses at various points in the film and the image jumps out at them in 3-D.

It wasn't just that, though...

It was this:


The image in the meme has been reversed. Here is the original...

Many factions emerged from the Paris May Days of 1968. While Danny the Red harangued the crowd, turning himself into a spectacle, a bulwark beavered away in the background with the end-game in their sights.

They became the New Left. Perhaps, that's where Blair got 'New Labour' from. He admired Trotsky as a young man and 'Education, Education, Education' could as well be transcribed or rewritten as 'Indoctrination, Indoctrination, Indoctrination', for that is what it is become: Woke schools teaching the Woke agenda to their captive audience.

All manner of nasty creatures crawled out of the political woodwork in those May Days, doing their damnedest to form a ‘worker-student alliance’ and, fancying themselves as ‘revolutionaries'. LSE students published all manner of journals, such as ‘Worker Student Bullet-In’!

They were 'cool' and I well remember being entertained in a SOAS mess hall as one of 'yer workers' by a student brandishing his cue stick and referring to it, provocatively, as a phallic symbol. You didn't go on to 'uni' in those days; you left school and went to work. Gosh, imagine, having to work for a living.

I no longer have a copy of that particular journal but I do still have, in my cupboard under the stairs a copy of ‘Ten Days That Shook the University’ published by King Mob Echo, English section of the Marxist ‘Situationist International’.

One such faction, the Situationist International was a curious blend of the ‘early’ Marx and nihilistic anarchism.

They applied the Marxist critique to their own situation in what they defined as student poverty; these were the fine-fettered sprogs of the well-to-do and the comfortably-off they espoused to despise!

E. P. Thompson recounts a letter to The Times from a Victorian gentleman in his carriage encountering a demonstration on London’s streets. A group of young men who broke away from this protest gave chase in most rowdy and threatening manner. The gentleman correspondent wrote, this being his main purpose in doing so, commenting on, to his surprise, how well dressed they were, not at all the lowly poor one might have thought would make complaint at their unfortunate condition! Idle students have been hard at their idyll, it seems, for all time…

Their analysis of capitalism took the form of Guy Debord’s Spectacular Commodity Economy – ‘Societe du Spectacle’...

Society is a spectacle upon which the masses engorge themselves that keeps them in awe and in submission.

Who would have thought that modern day Marxists, having bombed the base, seized the fort and taken the castle, simply by assuming themselves via the pantry into the state room, would actually employ such tactics to good effect to advance their own agendas with the 'narrative'. We are no longer 'half-way there’; we have come full term and have arrived - and bounded on with a 'great leap forward'.

We have been led down a rabbit hole by the nose and have willingly followed while they complete their goal of 'smashing capitalism' and the family - the 'evil patriarchy’ - under the guise of 'stake-holder capitalism’, climate change, Wokeness, a mad, frantic frenzy of diversity and inclusion which, just as education means indoctrination, translates as exclusivity and exclusion, all wrapped up as a spectacular commodity and sold to the gullible, engorged by the simple, each a sensation to obsess and capture and enrapture!

The Left is not a cohesive rump; it is more a collectivity of collectives. Is Bezmenov correct, then? Yes, but they are not an identifiable mass but a movement set on destroying what left there is of any common decency in the world. The West is at a crisis point at every level, economic, social - and spiritual. The players are diverse but inclusive, each with their own agenda, all part of the agenda. Players have crawled back out of the woodwork we thought we had laid them to rest in - all mentioned herein, given due attention in these pages.

Lockdown was not about a virus; it was not entirely about a vaccine: it was a process of conditioning the mind, the psyche, into a state of blithe acceptance and indifference to any and every attack upon the ‘narrative’ that any opposition could muster.

In lockdown, the masses were 'primed'. In lockdown, the masses were presented with a new spectacle to capture their attention and distract them - the global BLM insurrection against truth, heritage and tradition - the very spiritual soul of the West.

Present someone as a victim and even the most repugnant is given a polish and becomes somehow ‘acceptable’ or, at least, less repugnant.

If George Floyd were to have been judged by the ‘content of his character', he would have been found wanting. He was judged by the colour of his skin and he became a victim.

In lockdown, the masses were 'primed'. In lockdown the masses were conducted into a condition of stupor via a 'prime minister's brain' which directed them, through the medium of the mainstream TV media made available to them, as the one exclusive source of truth.

Kreskin called this the power of suggestion. In his TV series, 'The Amazing World of Kreskin', he would go amongst the audience and select people, apparently at random, but who would be amenable to suggestion. He invited them onto the stage. They would then exit the stage with Kreskin to be 'primed'. In one episode, he took them onto the roof. Via the microphone Kreskin took with him, you could hear cries of amazement. When he brought the group back down to the studio, he asked them what they had witnessed. Without fail, every one of them claimed to have seen flying saucers and nothing could convince them otherwise. 

Suggestion works best, Kreskin claimed, with people in groups. He said that, using suggestion, he could never make someone do something he did not want to do, but in a crowd, as a closed group, they could be primed to do however the suggester willed it. Responsibility and commonsensibility is lost.

On a mass scale, thus focussed on what the suggester is directing and informing, the mass of the population can be manipulated. Kreskin cautioned with a warning repeated over the years that despots and false prophets have often used such techniques to influence behaviour on a mass scale. Take, as good example, the Nuremberg rallies!

The masses, locked down, with a daily diet of direction from the triumvirate at their lecterns as their one source of truth, unquestioned and inviolable, are programmed! The appropriate 'triggers' will, again, enforce their compliance.

When you are confronted with the enormity of what you may have done to yourself, what else is there to do...? 

Lockdown was a process of conditioning the mind, the psyche, into a state of blithe acceptance and indifference to any and every attack upon the ‘narrative’ that any opposition could muster.

Reading the accounts that come out of China (PRC-CCP), should the question be put: Have we all gone stark, staring mad?

This article - COVID Policy Reinforces Chinese Communist Party Tyranny - concludes… “hundreds of millions of Chinese have more keenly felt the communist lash than before. And the negative impact appears to be most profound on the young, who are the future of both party and nation.

Along with a slowing economy, shrinking population, and increasing emigration, growing public anger might fuel opposition to Xi’s attempt to emulate Mao Zedong by imposing unlimited party and personal rule.”

Mao’s greatest support, of course, was among the young. The brutal, blind fanaticism of the Red Guards exploded into an orgy of mass psychosis that is not forgotten to this day.

The greatest support for WOKE is among the young whose belief system must not, may not, cannot, be challenged or countered in any way. The university is a ‘safe’ place. Your ideas must not be threatened by such challenge. Yet, the whole essence of the place of learning was and should be that ideas should be challenged to reaffirm their legitimacy.

Even in the closing years of the last millennium, the door had not been shut entirely on such an outrageous idea. ‘Heartbreak High’ was a cult teen TV series which came out of Australia. In one episode, one of the major characters, a student of Greek ethnic origin, was given the daunting task of defending the status quo against burgeoning calls for a republic - the motion that this house supports a republic - in a debate with another school, even though he himself supported such calls for Australia to become a republic. Reluctantly, he put together a case, an argument, against the motion.

It forced him to question himself and his own long-held beliefs. His argument went to his roots, his Greek heritage. Heritage is important. It is where we have come from and guides us on our journey through life. Accepting these differences is true diversity, not the ‘diversity’ that imposes conformity.

He argued the case that it was the inability of the Greek city-states to band together that caused Greece to fall and equated this with Australia seceding from the British Commonwealth. A similar argument could be put in regard to the UK nations, that we are, for instance, English, Scottish, but together we are British and, together, we are stronger against the EU yoke that still seeks to weaken us by dividing us.

Kreskin cautioned us with a warning oft repeated over the years and it has come to pass. C. S. Lewis cautioned us thus:

And it has come to pass.

But this medical tyranny was never for our own good. For decades, Klaus Schwab's World Economic Forum has been positioning itself as a provisional world government. His Young Global Leaders are prominent worldwide. He has long floated the concept of a great reset, a ' fourth industrial revolution'. This has very skillfully been accommodated by commandeering the extensive resources of the Fourth Estate - via the entryist tactics of the Fourth International!

The Covid-19 measures were promoted by the PRC-CCP and adopted by the WHO. They went into force worldwide with a vigour unprecedented and unseen in our lifetimes. The WHO is currently making a power grab with a vigour unprecedented and unseen in our lifetimes to impose its suzerainty.

According to the Clarence House Twitter feed, the Great Reset has begun...


This  is an unelected individual promoting the policies of an unelected global body of elitists!

As a future constitutional monarch, Charles would do well to remember his place and respect parliamentary authority.

He might take due note and remember the fate of his namesake... 

His fate was sealed by his treason!

The Commons declaration of 4 January 1649:

"The Commons of England, in Parliament assembled, do Declare, That the People are, under God, the Original of all just Power: And do also Declare, that the Commons of England, in Parliament assembled, being chosen by, and representing the People, have the Supreme Power in this Nation."

John Bradshaw: "Justice knowes noe respect of p[er]sons"

Deuteronomy 1:17, ‘Ye shall not respect persons in judgment; but ye shall hear the small as well as the great; ye shall not be afraid of the face of man; for the judgment is God's’.

Parliament, however, has completed its own assault on the hard won democratic principles of the home of parliaments.

Parliament, today, is also in contempt of the people!

This last post must come full circle with the absolute proof the death pathways are alive and putting the boot in. They kicked in with a vengeance applying the Covid-19 policies of the government, fully supported on both sides of the house.

And this document (right) demonstrates and attests to that...

This is the symptom control protocol for Covid-19 patients downloaded from Brighton and Sussex NHS Trust.

The government purchased a huge stock of Midazolam as part of their Covid-19 measures and this was liberally employed in care homes throughout the land.

Another family member has been taken.

I wrote to my MP in August 2020:

As your constituent and having reported to you the circumstance of my brother's death, I had thought there might be some comment and commitment from you on the blanket DNR and end of life orders in elderly and disability care settings. This, especially, as this arose entirely through the lockdown measures being imposed. Alarmingly, safeguards such as those in regard to death certification have been relaxed under the Coronavirus Act, opening a Pandora's box of potential malpractice. I mentioned this to the Coroners Office and they said that it had been a subject of concern for them.

Why was Form 5 Cremation Certificate for deaths relating to Covid-19 under the Coronavirus Act removed? It was a licence for murder and to gerrymander statistics! It gave any Shipman out there a veritable field day to do their very worst. Or was it about keeping COVID 'deaths' high enough to justify the continuation of the mask and lockdown fascism, preventing autopsies and second opinions to determine the 'withs' from the 'ofs'?

I now request your assurance that there is not something sinister going on to deprive the citizens of this land of their hard-won freedoms indefinitely and permanently. A drift soon becomes slip and slide and liberties hard won are easy lost.

Mr. Johnson is now complicit. He is either a buffoon or part of this agenda to instill fear into the people of this land to comply with and accept authoritarian measures and dictatorial powers to restrict and control a free people. Can a Conservative government really be doing this? Really? Please respond with your assurance that this is not so and you are seeking an immediate inquiry into the DNR orders, the end of life orders and the use of sedation in elderly and disability settings.

Conservatives do not 'shut' down their opponents; they 'shoot' them down with sound and reasoned argument. Medicine has become politicised and weaponised. No-one is permitted to question the narrative. The politics of fear is permitting an inexorable drift into a socialist fascist world order. We are witnessing the deconstruction and destruction of western democracies. We are sleepwalking into an awful perfidy of the people by those entrusted to govern them.

History will not look well upon 'this time'. Historians will debate however did they permit this to happen? And they shall, for truth and justice will win the day - and the say - ultimately, as every despotism has found to its dismay.

A final finalé -

It was US election night. Trump was soaring ahead. Suddenly, late into the evening, my daughter, the noted and renowned researcher, Louise Smith, commented that the count had stopped. She remarked: They don't want Trump to celebrate his win tonight. It was all rather odd.

Next day, the count continued. Biden had come out of nowhere to overtake Trump on the rails. What had happened...?

The election had been 'fortified'!

It is easy to pretend to yourself that something can't happen because it couldn't happen...

The US is not a Banana Republic!

But it did happen.


Thursday, 30 June 2022

Blog Supplemental –

"One such faction, the Situationist International was a curious blend of the ‘early’ Marx and nihilistic anarchism."

“Destruam et ædificabo” appeared on the cover of Proudhon's fundamental work, The System of Economic Contradictions, or The Philosophy of Poverty. Proudhon was a French socialist in the anarchist tradition. Today, he might be called a Libertarian Socialist. Some consider him the originator of Anarchism.

Others allot this title to Godwin, author of Political Justice and Caleb Williams, in the individualist tradition. Of course, everyone is familiar with the moral tale, Frankenstein, authored by his daughter, Mary Shelley. In her dedication, she warns Godwin and his poetic disciples that their revolutionary writings could have dire consequences, as was borne out in the tragic outcomes of the uprisings of the time.

Her mother was the grand feminist of her time, Mary Wollstonecraft. She would, without doubt, have frowned upon the destruction and murder of womanhood we are witnessing today under the guise of Liberal recognition and 'inclusion' of the new oppressed class/minority of non-binary Transgenderists!

Destruam et ædificabo: What does this Latin phrase mean? It means: Destroy and build or, through destruction, rebuild.

That sounds familiar...

Build Back Better...?

They were only 'halfway' there...

"2013/14 has been a crucial year for end of life care as well as NCPC & the Dying Matters coalition. It has marked the halfway point of the 10-year End of Life Care Strategy..."


In 2020, it arrived. Over the past two years, the Strategy has come to fruition and, under the the awful dictats (Yes, I do use that spelling, like the plural of bus is busses!) of the Coronavirus Act, has decimated the population of care homes throughout the land, on a par with the killing that proceeded on an industrial scale at the height of the LCP terror!


Over the past two years, they have also taken down and destroyed the economy, through destruction, to rebuild!

When the oppressed - or, rather, those who assume their 'birthright' and commandeer their protest, like the students mentioned in that letter to The Times! - rise up and become, themselves, the oppressor, to impose their own vile tyrannies, as has happened, we are in dire peril, indeed. 

Victor Serge, in his 'Memoirs of a Revolutionist', recounted how Russian anarchists, in their revolutionary zeal, abolished money, reducing exchange to barter, creating economic chaos and ruin. The Bolshevik terror was more complete than that imposed by any Tsar! it had its own self-justification by claiming to be the party of the Proletariat, actually identifying itself as the Proletariat, the class that will rise from the corpses of the Bourgeoisie to seize the next stage of history! That Marxist historical determinism has progressed since then and is now outdated. We are now, effectively, in a 'post-Marxist' world.

Schwab's World Economic Forum has been positioning itself as a provisional world government. His Young Global Leaders are prominent worldwide. He has long floated the concept of a great reset, a ' fourth industrial revolution'. This has very skillfully been accommodated by commandeering the extensive resources of the Fourth Estate - via the entryist tactics of the Fourth International!

Europe - the EU - is under radical pressure to become a political as well as an economic union to face the threats that are manifesting on all sides, on all fronts.  Will the outcome be a German-dominated Mitteleuropa - a Fourth Reich...? This mortal enemy is, once more, rearming. 

Where did all the Nazis go, long time passing...?

The Warsaw Ghetto uprising showed the Jews were not the willing sheep to be led to the slaughter that the 'Herrenvolk' thought they were and could be a force to be reckoned with! Yet, how were they led to the showers?

You may ask of yourself, how have you been led - if you have been - to accept the jab, not once, but twice and thrice and more? Are you willing to stand up like those brave heroes and, likewise, be a force to be reckoned with against the Herrenvolk Globalists?

Thursday, 30 June 2022

Blog Supplemental Additional –

There is so much going on, at every level, it is hard to tell what actually is going on.

Are we seeing a re-run of the 30's as some commentators have pointed out? Are we again witnessing the carve-up of Europe? Is that what Ukraine is all about? Back then, it was about the restoration of what was viewed as territorial integrity on both sides, the Soviets and the Nazis.

The Nord Stream deal was signed off by Schröder in the final days of his Chancellorship, before handing over to Merkel...

...and assuming his post as head of Nord Stream's supervisory board!

Powerful German commercial interests were present, as they were at the Red House Hotel.

"Abs was one of the most important figures in Germany's post-war reconstruction. It was largely thanks to him that, just as the Red House Report exhorted, a 'strong German empire' was indeed rebuilt, one which formed the basis of today's European Union.

Abs was put in charge of allocating Marshall Aid - reconstruction funds - to German industry. By 1948 he was effectively managing Germany's economic recovery.

Crucially, Abs was also a member of the European League for Economic Co-operation, an elite intellectual pressure group set up in 1946. The league was dedicated to the establishment of a common market, the precursor of the European Union."

Was this just self-interested, pecuniary gain on the part of Schröder or part of some secret agreement 1930's style?

There is so much going on, at every level. The PRC/CCP Belt and Road Initiative spans the globe. The PRC/CCP virus has been the blunt instrument that has taken down the world's economies. Who is the grand puppet-master, if there is one?



Thursday, 21 July 2016

Liverpool Care Pathway - The End

In the beginning was the end and in the end is the shape of things to come.






The forces, routed, have reformed their regiments and renewed the Long March to 2020.

Fahrenheit 451 (Ray Bradbury, 1953)
“We must all be alike. Not everyone born free and equal, as the Constitution says, but everyone made equal. Each man the image of every other; then all are happy."
- Fire Chief, Beatty
Revisionist History:
"Established 1790, to burn English-influenced books in the Colonies. First Fireman: Benjamin Franklin."
- Fireman’s Rulebook
"Do you ever read any of the books you burn?"

He laughed. "That's against the law!"

"Oh. Of course.”

"You're not like the others. I've seen a few; I know. When I talk, you look at me. When I said something about the moon, you looked at the moon, last night. The others would never do that. The others would walk off and leave me talking. Or threaten me. No one has time any more for anyone else. You're one of the few who put up with me. That's why I think it's so strange you're a fireman. It just doesn't seem right for you, somehow.'"

"I sometimes think drivers don’t know what grass is, or flowers, because they never see them slowly. If you showed a driver a green blur, Oh yes! he’d say, that’s grass! A pink blur! That’s a rose garden! White blurs are houses. Brown blurs are cows. My uncle drove slowly on a highway once. He drove forty miles per hour and they jailed him for two days. Isn’t that funny, and sad, too?"

They crashed the front door and grabbed at a woman, though she was not running, she was not trying to escape. She was only standing, weaving from side to side, her eyes fixed upon a nothingness in the wall as if they had struck her a terrible blow upon the head. Her tongue was moving in her mouth, and her eyes seemed to be trying to remember something, and then they remembered and her tongue moved again: "Play the man, Master Ridley; we shall this day light such a candle, by God's grace, in England, as I trust shall never be put out."

How inconvenient! Always before it had been like snuffing a candle. The police went first and adhesive-taped the victim's mouth and bandaged him off into their glittering beetle cars, so when you arrived you found an empty house. You weren't hurting anyone, you were hurting only things! And since things really couldn't be hurt, since things felt nothing, and things don't scream or whimper, as this woman might begin to scream and cry out, there was nothing to tease your conscience later. You were simply cleaning up. Janitorial work, essentially. Everything to its proper place. Quick with the kerosene! Who's got a match?

Fahrenheit 452 (Reality Check, 2016)

"The Constitution, as a charter of negative liberties, says what the States can't do to you, says what the Federal Government can't do to you, but it doesn't say what the Federal Government or the State Government must do on your behalf." 
- Commander in Chief, Obama
Revisionist History:
NHS England's first strategy for end of life care in England, published in 2008, has succeeded in reversing the trend of increasing the proportion of deaths taking place in hospital.  
Transforming end of life care in acute hospitals - 'How to' guide

-  Express
The LCP Review itself stated: “There are no precise ways of telling accurately when a patient is in the last days of life.”

DNR also provides a moral dilemma. A passive decision to not intervene to save a life is tantamount, morally, to an active decision to take a life.

They are being sent home to die...

The final word must go to the Archdeacons of the Pathway, Chairman Ellershaw et al –
“It might strike lay people as odd, but there is little empirical data on the physician skill of diagnosing imminent death. It would appear that much remains to be learned.” There is limited evidence in medical literature of how the dying phase can be identified.
Diagnosing Dying
That said and done, there are those who boldly go where none have gone before:

The Mail
Priority assessments and downgraded responses.

The paramedic took a quick look.

GSF Barton Method assessment made, the paramedic follows the Lakhani Recommendations and goes on standby.

Further reading -
Liverpool Care Pathway - On The Final Stretch

Mail Online
Ambulance crews responding to 999 calls are being alerted if a patient is on a list, and can refuse to take them to hospital if they have previously expressed a wish to die at home.

Further reading -
Liverpool Care Pathway - Second Class Delivery

Liverpool Care Pathway - The Terminator
We care. We can help you end your life. In Ontario, doctors are being invited to register their interest in providing assistance to die.

Federal legislation, passed on June 17, 2016 has amended the Criminal Code to permit the taking of life.

Active killing is become a medical therapy.

Doctors and nurse practitioners in Ontario can now provide medical assistance in dying. There is even a referral service available should there not be a doctor or nurse practitioner available to provide treatment.

Your treatment is your right. You may not be abandoned.

And when the swing is complete, it will have gone full circle:

GPs have been dropped between a legal rock and a hard place. While the Data Protection Act demands that personal data is handled transparently and held in confidence, the Health and Social Care Act has stated that GPs are legally required to provide data to the Health and Social Care Information Centre for the Care.data programme with presumed consent.

Presumed consent is the positive rights and negative liberties model. It is the 'deemed consent' model adopted for organ donation in Wales.

Care.data pseudonymised and anonymised personal data. Even so...

For purposes of demonstrating to Commissioners 'value for money', we are required to pseudonymise and anonymise clients data online using reference numbers instead of names. The reference numbers consist of the Scheme identifier and the tenancy identifier. Effectively, anyone who is determined to discover the client’s identity may do so.

Care.data pseudonymised and anonymised personal data, likewise, has not been impregnable to anyone determined to source identity.

No more...
The NHS announced that the scheme to store all patient data on a single database would be cancelled following the publication of a long-awaited review from Dame Fiona Caldicott, the National Data Guardian (NDG).
In response, NHS England said: “In light of Dame Fiona’s recommendations, NHS England has taken the decision to close the care.data programme. However, the government and the health and care system remain absolutely committed to realising the benefits of sharing information, as an essential part of improving outcomes for patients.

“Therefore this work will now be taken forward by the National Information Board, in close collaboration with the primary care community, in order to retain public confidence and to drive better care for patients.”
-  nhe

The NIB was set up to advise the Secretary of State for Health on the use of powers to set aside the common law duty of confidentiality in England where identifiable patient information is needed and where consent is not practicable.

NIB now works in collaboration with the DOH to digitalise the NHS and tweets as NIB @Health_2020.

The goal is a radical alliance of  Health and Social Care to move forward the digital revolution regardless.

Whatever impediment there is placed in the path the pathway will be followed...

And they are all back where Wee Belong...

It is 'not new or additional guidance' for it is only what has gone before they once belonged.

"It builds on legacy work from NHS Improving Quality and provides practical advice and support for frontline clinicians and leaders on ‘how to’ identify, lead and implement change for themselves to improve their local services in collaboration with their local partner organisations across their community."
It is now 'personalised care' but it is the same graphics and annotations.

The same questions are asked, the same documents sourced -

- Route to Success How To Guide - December 2015

And are we come full circle -
Liverpool Care Pathway – "Six Steps To Success"
From the Fireman setting fires, to the Medics taking lives...

So, get back John, John, get back to where you Wee Belong!

Some final reading for the end -
Liverpool Care Pathway - And Who Is The Victim?

Liverpool Care Pathway - Be Not Disarmed By The Caring Smile

Liverpool Care Pathway - 111, EPaCCs And The 999 Downgrade

Liverpool Care Pathway - The LKP Can Deliver


Sunday, 19 June 2016

Liverpool Care Pathway - Bold As Brass And As Brazen

And when the swing is complete, it will have gone full circle...






This is Commissioning person centred end of life care –


This is all just overboard PC or sounds like it; this is all just puff ‘n stuff for a Mission Statement –
We have:
•Given due regard to the need to eliminate discrimination,
harassment and victimisation, to advance equality of
opportunity, and to foster good relations between people
who share a relevant protected characteristic (as cited
under the Equality Act 2010) and those who do not share
it; and
• Given regard to the need to reduce inequalities between
patients in access to, and outcomes from healthcare
services and to ensure services are provided in an
integrated way where this might reduce health
inequalities
•We have also given due regard to the responsibility that
CCGs have a duty to actively involve local people as
stated in the Health and Social Care Act [2006 amended],
2012 Health and Social Care Act (amending the NHS Act
2006) c. 7 PART 1 Further provision about clinical
commissioning groups Section 26 Section 14z(2)1,
Health and Social Care (Safety and Quality Act) 20152.
What is this? What has this got to do with health care? Sorry, I forgot. This is not health care; this is end of life care.

Meanwhile...

The revisionists are hard at work attempting to rehabilitate Joe Stalin. This is classic revisionism:

This is the Transforming end of life care in acute hospitals - 'How to' guide -


NHS England's first strategy for end of life care in England, published in 2008, has succeeded in reversing the trend of increasing the proportion of deaths taking place in hospital. 
The EoLC Strategy actually produced the medical holocaust that was the LCP.


The EoLC strategy subsequent to the discrediting of the LCP has been to carry on as before but call it something else and, using EPaCCS, shunting the punters out the hospital back into the community and, better still, signed off onto an AD that keeps them in the community setting.

Here is NHS England with "Commissioning person centred end of life care – a toolkit for health and social care" -


Providing high quality end of life care that is truly centred around the needs of the individual and their loved ones is an important outcome to aim for. Given the complexity of ensuring all the patient’s needs are met, wherever possible, requires all the agencies to work together.
As Lenin might have asked: What is to be done?

What is all this obsession about ‘end of life’ care? What about just basic ‘care’?

Let’s look at that statement again with some basic amendments…

“Providing high quality end of life care that is truly centred around the needs of the individual and their loved ones is an important outcome to aim for. Given the complexity of ensuring all the patient’s needs are met, wherever possible, requires all the agencies to work together.”

THAT should be basic to ALL care. That should be at the heart of all care. So, why isn’t it?

And all that Mission Statement twaddle above…?

Of COURSE there is discrimination. Just ask the Cancer Drugs Fund why Ibrutinib was suddenly ‘disappeared’ off the NHS website last November/December!

Everyone must have fair and reasonable access to dying but not fair and reasonable access to living.

This is Ambitions for Palliative and End of Life Care -



The building blocks for achieving these ambitions:
Honest conversations
Person centred care 
Helping to take control
Clear expectations
These may be ‘said and dones’ for all care. To single out ‘end of life’ is discriminatory. Determining ‘end of life’ and ‘diagnosing’ dying is a self-fulfilling prophecy.

Ambition statements:
“I live in a society where I get good end of life care regardless of who I am, where I live or the circumstances of my life.”
“I live in a society where I get good end of life care regardless of who I am, where I live or the circumstances of my life.”
“I get the right help at the right time from the right people.”
“Wherever I am, health and care staff bring empathy, skills and expertise and give me competent, confident and compassionate care.”
These are musts for all care, not just EoL care. But it isn’t.

Forward Ambitions for Palliative and End of Life Care:
“Death and dying are inevitable. Palliative and end of life care must be a priority. The quality and accessibility for this care will affect all of us and it must be made consistently better for all of us. The needs of people of all ages who are living with dying, death and bereavement, their families, carers and communities must be addressed, taking into account their priorities, preferences and wishes.”
A New Perspective:

Death and dying are inevitable; therefore, care is always a priority. The quality and accessibility for this care will affect all of us and it must be made consistently better for all of us. In this world 'nothing can be said to be certain, except death and taxes' [Ben Franklin]. Everyone, of what any age, is living with dying, death and bereavement. Death does not differentiate; Death is the ultimate leveller. Therefore treasure life. Treasure the life we create in the womb. Treasure life until the end of life. Life is too readily snuffed out. Life is not too readily ‘reassembled’ [Johnny Five]. Life and concern for life is always paramount because life is precious and living matters.

There is a Foreword in the extended document -


The Foreword is signed off by –

Professor Bee Wee National Clinical Director for End of Life Care, NHS England
Dr Jane Collins Chief Executive, Marie Curie
John Powell Policy Lead for End of Life Care Association of Directors of Adult Social Services

The Wee Belong of the Leadership Alliance and her stiff unswerving advocacy of the LKP is well known to readers of these pages...
Liverpool Care Pathway - End Of Year Review Of Outcomes
Marie Curie launched and promoted the LKP via the DoH EoLC Strategy. Marie Curie's own Chairman Ellershaw, devised the LKP...
Liverpool Care Pathway - Cast Iron Protection

Liverpool Care Pathway - The Report
Marie Curie's new leader, also a staunch supporter of the LKP, has had mention -
Liverpool Care Pathway - The Trouble Bubble Shooter
John Powell has not had prior mention but the joining up of health and social care as cautioned by James Churchill some years ago has been discussed previously...
Liverpool Care Pathway - Crying Wolf

Liverpool Care Pathway - When The Funding Had To Stop

Liverpool Care Pathway - The Reaper At the Town Hall Door
The Health and Social Care Economy has arrived. Health is taking over social care, seamlessly, in a joint funding operation -
Liverpool Care Pathway - And Who Is The Victim?

The National Palliative and End of Life Care Partnership which publishes this document includes –

National Palliative Care Nurse Consultants Group

Readers of these pages will be acquainted with this group(s) and their lead, Margaret Kendall...
Liverpool Care Pathway - Of Deception And Infamy

Liverpool Care Pathway - Of Deception And Infamy (Part II)

Liverpool Care Pathway - Curiouser And Curiouser And Curiouser

Liverpool Care Pathway - Catch Up EoLC
And here they are again, bold as brass and as brazen.

Here is the Treatment Escalation Plans (TEP) from Royal Cornwall -

Review Date: 24 September 2015
Next Review: Aug 2016
Reviewed by: Jay Over - Resuscitation Officer

• A TEP must be completed if the answer to the life expectancy question “Would
you be surprised if this patient died within next 6-12 months? is no.
• A TEP must be completed for all patients who are at risk of deterioration/cardiac arrest.
• The responsibility for making treatment decisions including resuscitation rests with the consultant in charge of the patient’s care.
• In the absence of a consultant, other doctors with at least 3 or more years registration with the GMC (deputy) may make these decisions in urgent circumstances for adult patients only; CT1 and above. If there are any doubts about the right course of action, a consultant should always be contacted to discuss what to do.

An adult, over 18 years, with capacity can refuse treatment.
A patient cannot demand resuscitation which is not clinically indicated.
The Version 4 Decision Record contains the TEP -

The TEP document itself advises use of the GSF Barton Method as a prompt to enact the TEP.

Elsewhere, the document states:
1.3. Nevertheless, it is not an appropriate goal of medicine to prolong life at all costs with no regard to its quality or the burdens of treatment on the patient.
It may sound commendable to say, as this document does, that 'it is not an appropriate goal of medicine to prolong life at all costs with no regard to its quality or the burdens of treatment'.

However, a decision taken to not act to save a life is tantamount to a decision taken to take a life...

It is a cold and calculating judgement call over-riding the natural emotional response to plunge in and help -
Liverpool Care Pathway - On The Final Stretch

Liverpool Care Pathway - Life And Death Café

Liverpool Care Pathway - Doing The Addition

Wiltshire are also using TEPs -

Resource Pages on the Wiltshire website are using video presentations courtesy of South Devon TEP.

One of these is copyright 2012, the height of the LCP medical holocaust.

And it's business as usual...
“They (hospital staff) said they don’t really operate on people over 80-years-old.”
“They said ‘do you want to put him through that’. We said he has no chance of life without it.”
- Alison Turner
Liverpool Care Pathway - After The Review, After Everything, They're STILL Killing People
Over in the States, Affordable Care sounds like it means making care affordable; it doesn’t. It means what it means on this side of the pond; making care affordable for the provider, which means rationing care.

Rationing care means downsizing treatment expectations.

In this world nothing can be said to be certain, except death and taxes [Ben Franklin].

The circle is come full circle...

- The Mail
and complete...
Liverpool Care Pathway - Whether Shove Comes To Shovel, It's Still A Spade
But one last final thought to leave you with -
Liverpool Care Pathway - Advancing The Will To Live