Liverpool Care Pathway - Litigating The Litigants

Fool me once, shame on you; fool me twice, MORE shame on you!






We have been very busy addressing a number of matters at our little project. Everything from dealing with a flood and temporarily re-accommodating clients to answering such longstanding and profound questions as:

When is a HMO (House in Multiple Occupation) not a HMO?

When it’s a... HMO?

We fit the description for a HMO and as such the local Council could shut us down for falling down on compliance issues which we constantly chase up and get slapped down on.

We fit the description for a HMO but a HMO is only a HMO if it has a private landlord.

We fit the description for a HMO; however, because we are and have a social landlord it seems they can get away with murder. We hope and pray that ‘murder’ will remain a metaphor.

It does seem that this grand alliance of State, Third Sector and Smart Alecs can and do get away with it and, when they can’t, can afford themselves of the protective umbrella the Alliance provides.

This is Nursing Times –

Fitness to practise hearings against five midwives from the University Hospitals of Morecambe Bay Foundation Trust have been delayed because of legal action by their defence lawyers, Nursing Times’ sister title HSJ has learned.

The Nursing and Midwifery Council had been intending to hold misconduct hearings against five midwives involved in the treatment of baby Joshua Titcombe, who died in October 2008 at Furness General Hospital.

The midwives are Greta Dixon, Holly Parkinson, Joanne Watts, Catherine McCullough and Lindsey Biggs.

At a preliminary hearing last month, lawyers acting for all five midwives revealed they were planning to lodge legal applications before the misconduct hearings take place. In a letter, seen by HSJ, the NMC said this could “substantially affect the progression of all of the cases”.

Joshua’s father James Titcombe, who campaigned for an independent inquiry into poor care at the hospital, told HSJ he was “saddened and upset” by the delays.

He said: “It’s vital and in the public interest that open hearings take place so that the truth can be properly established. It’s coming up to what should have been Joshua’s seventh birthday and it’s disgraceful that the NMC processes have taken so long.

There is legal protection for those who stand accused but what legal redress for the pursuant of the complaint?

James Titcombe has been invited to participate on the panel of a review led by Baroness Julia Cumberlege into NHS maternity care provision following the disclosures of the Kirkup Inquiry. Members of the public and professionals are being invited to share experience, suggestion and opinion.

Denise Charlesworth-Smith was invited to participate on the panel of a review led by Baroness Julia Neuberger into LKP care provision following the disclosures  that trickled then flooded out of the medical holocaust of the LKP. Members of the public and professionals were invited to share experience, suggestion and opinion.

We won't get fooled again...

This is Nursing Times –

Don't be taken in, James, that your opinion may count or be counted.

This is Denise on BBC Radio Norfolk -

Denise Charlesworth-Smith

I think it stinks to be quite honest; I think it’s a total cover-up. And I think it’s a case of, ah, that I’m purposely being blocked from going to this, em, Newmarket Workshop and, as far as I’m concerned, this is something that I had to fight to get onto; I had to fight to get down to meeting in London, which was held in September where I first found out that there were going to be Workshops and, now that there are Workshops being dotted around the country, I think the only people who are going are the people who supported Bee Wee on End of Life Care. I don’t think there’s anyone there who, em, has had a negative experience of it so they can actually put a balanced view across to what they’re proposing. So, I think the whole thing is a total farce. I’m absolutely livid.

Further reading -

Liverpool Care Pathway - The Bee Wee Consultation

Once again, the focus is some ‘high quality’ protocol ordained from on high, not the individual patient in front of you, their needs, their demands.

Tip your hat to the new constitution
Take a bow for the new revolution...
We won't get fooled again?

Beware the zealot pushing the agenda.

Pertinent and essential reading -

Liverpool Care Pathway - Who Monitors The Monitors And The Monitors Of Monitors...?

In 2003 the Shipman inquiry recommended significant changes to the way deaths are recorded. The existing system was believed to be deficient and wanting.

Those reforms were never fully introduced.

Shipman pursued his own care pathway with the same zeal that the Morecombe zealots pursued their purpose.

In The Report of the Morecambe Bay Investigation Dr. Bill Kirkup recommended -

“the appointment of medical examiners, initially proposed by Dame Janet Smith as a recommendation of the Shipman Inquiry, subsequently endorsed by the Luce review, put into enabling legislation in 2009 but not yet implemented. It is our view that implementing these proposals should be reactivated as the best means to provide the necessary scrutiny, not just of maternity-related deaths, but of all deaths.”

This is the Report on the Pilot Centres set up in 2009 -

An initial aim of death certification reform was -

To ask the next of kin whether they had any concerns about the death that might justify further action (subsequently referred to as ‘The Shipman Question’)

The report goes on to say -

Implementation was subsequently strongly supported by the Francis Report into the failings of Mid-Staffordshire NHS Trust. Francis recognised that asking the relatives to identify their concerns, an approach he referred to as ‘The Shipman Question, was also a valuable way to obtain independent warnings about failing healthcare providers. Implementation was similarly urged by the Morecambe Bay report into maternity services.

Asking the Shipman Question is contentious and controversial. They would far rather ask the Surprise Question (The Barton Method).

And now we have gone full circle to the report in The Plymouth Herald and out of hours GPs ceasing to verify deaths in Care Homes, just the sort of places where those Surprise Questions are asked.

Asking the Shipman Question might just complicate things.

Further reading -

Liverpool Care Pathway - Another Committee, Another Review

Liverpool Care Pathway - They Do Not Have The Paperwork

Liverpool Care Pathway - A Rose By Any Other Name

Liverpool Care Pathway - In Hope We Trust


Liverpool Care Pathway - The Six Million Dollar Plan 

The final say from Dr. Suzy Lishman, president of The Royal College of Pathologists –

There was a surge in media interest in medical examiners in January to coincide with the 15th anniversary of Harold Shipman’s conviction. I was interviewed live on the Today programme with Chris Bird, whose mother was one of Shipman’s victims. To hear him speak so powerfully reinforced just how important the role of medical examiner could be.

An eight-minute interview on Going Underground on RT UK, a global online news service, was aired several times and gave an opportunity to explore the topic in more depth. Letters outlining the main issues were sent to parliamentarians, including the Prime Minister and Secretary of State. Shadow Health Secretary Andy Burnham quoted the College statement in his response to the Francis report on whistle-blowing in the House of Commons in February and Liz McInnes MP referred to it in the discussion of the Morecambe Bay inquiry. In that debate, Secretary of State Jeremy Hunt said, “I can only commit now to us introducing independent medical examiners as soon as possible. We are wholeheartedly committed to this,” which is probably as much as we can hope for at this stage in the parliament.