Liverpool Care Pathway - The Customer Is Not In A Position To Complain

This is the National Audit Office [scroll to item 16] -

End of life care

Executive Summary

National Audit Office Value for Money Report

Approaches to improving the delivery of end of life care

Fifty four per cent of general nurses and a third of doctors reported being trained in the use of at least one of the three National Institute for Health and Clinical Excellence (NICE) recommended approaches to end of life care (Gold Standards Framework, Liverpool Care Pathway or Preferred Priorities for Care). For those specialising in palliative care, the figures were 91 per cent of nurses and 95 per cent of doctors. These approaches, rolled out as part of the End of Life Care Programme between 2003 and 2007, are well regarded by a range of users and both doctors and nurses reported that their use had improved their confidence in delivering end of life care. There has, however, been little measurement of the benefits for patients of using these approaches and the direct benefit to patient care associated with their use has yet to be fully demonstrated. What research has been done has shown that their use can decrease unnecessary hospital utilisation and increase the likelihood of people dying in their preferred place of care.

The training is there. If the training has failed, then look to the trainer. Dr. Bee Wee...?

The financial benefits are there through a 'decrease in unnecessary hospital utilisation'.

The health professionals, the doctors and nurses, are very happy with the end of life pathways and report that their use has 'improved their confidence in delivering end of life care'.

However, there has been -

"...little measurement of the benefits for patients of using these approaches and the direct benefit to patient care associated with their use has yet to be fully demonstrated."

Really...? The most important person, the recipient, is an unknown quantity.

Well, it might be insensitive or inappropriate to ask them how it's going. 

And there is the profound difficulty, of course, in ascertaining how it went in that the person on the receiving end of this tool is, well...dead. The customer is not in a position to complain.

Shall we call in the clairvoyant?