Thursday, 3 January 2013

Liverpool Care Pathway - The Conceit Of The Arrogant


Everywhere, there is tragedy and the conceit of the arrogant.

A sad and sorry tale to tell, this was posted on Patient Opinion -


"My late wifes treatment or lack of it"


Posted by caring (as a relative), 
My wife suffered several strokes over a long period of time, the care she received was in most cases disgusting, over time she got worse getting very weak.
One day a nurse said perhaps she is in the last stages of dementia, my reply was that must apply to all stroke victims as the brain is damaged a bit more each time, as my wife had difficulty swallowing I requested a stomach tube be fitted the Doctor replied it will have no advantage, well I think it would have been an advantage to my wife.
Each time she was admitted after that she was just left to lay in bed with no attempt to get her up, she got weaker as time went on and twice she was in need of surgical intervention but was turned down as being too weak to go through with an operation, she developed pressure sores with the heal of one foot turning black.
My wife was then put on the Liverpool Care Pathway with little choice from myself her husband and carer. The fastest I have seen them move was when they withdrew her fluids and nasal tube that they promised me they would keep to administer her medication but silly me I trusted them, there was no intention of giving her any medication.
My wife was transferred to a private care home where she died within two days. that is another statistic that will not be on your books as she died away from your Hospital.
A week later on the day of her funeral the post had tried to deliver a letter and I should collect it the next day, it was from the N H S saying they had agreed to pay for my wife's continuing care. thank you for that, you have proved that you mess up all the time even after death.

Liverpool Care Pathway - The 2013 CQUIN As Endorsed By Mr. Cameron

FORENOTE:

A new national CQUIN goal has been introduced for use in 2012-13.


An estimated 25% of acute beds are occupied by people with dementia. Their length of stay is longer than other people and they are often subject to delays on leaving hospital.

This particular goal is to help identify patients with dementia and other causes of cognitive impairment, alongside their other medical conditions and to prompt appropriate referral and follow up after they leave hospital.
There are more bed-blockers to shift. And where will this lead...?
The Mail continues to draw attention to the CQUIN payments system in the hospital setting but, as has been reported in these pages, this now extends into District Nursing and General Practice. CQUIN is, no doubt, also involved in the spread of the GP death lists and the use of LCP, for instance, in St. Mungo's and elsewhere.

Dementia is added to the GP watchlist.

This is Mail Online -



Dementia tests will make older patients 'scared to visit their doctor', claim GPs

  • David Cameron has made tackling dementia a 'personal priority'
  • Patients could be quizzed about their memory when they visit their GPs on unrelated matters

A plan to improve dementia diagnosis rates by quizzing anyone over the age of 75 about their memory will put older patients off visiting their doctor, claims a concerned group of GPs.
 
Prime Minister David Cameron, who has made tackling dementia a 'personal priority', wants older people to be checked when they visit the doctor for any reason.

GPs will be paid for asking questions about patients' memories with anyone who admits to having problems being offered a screening test to see if they are at risk.

GPs fear a proposed drive to tackle dementia diagnosis rates could put older patients off from visiting their doctors for unrelated matters
GPs fear a proposed drive to tackle dementia diagnosis rates could put older patients off from visiting their doctors for unrelated matters

But many GPs fear patients will be put off visiting the doctors, even when suffering potentially serious health problems, because they will not want to be diagnosed with the disease.

Former president of the Royal College of GPs Dr Iona Heath was one of the doctors who signed a letter which appeared in the Daily Telegraph.

She said: 'This is another step on the road to obsessive diagnosis, and turning people into patients without any notion that it might cause more harm than good and divert resources.'  

About 800,000 Britons are currently being treated for dementia with another 400,000 thought to suffer from it but have not been diagnosed.
Prime Minister David Cameron has made tackling dementia a 'personal priority'
Prime Minister David Cameron has made tackling dementia a 'personal priority'
Last month David Cameron announced plans for a £2.4million project to train a million volunteers to spot the illness and care for patients.

One million 'dementia friends' are to be trained to spot the symptoms of the condition and given advice on how to provide practical help to Britain's estimated 700,000 sufferers.

The GPs' letter reads: 'A diagnosis of dementia is a life-changing event.

'The Government's NHS Mandates states: 'Dementia is the illness most feared by people in England over the age of 55. 

'There is a danger that older patients will avoid visiting their doctor with health problems, for fear of being given a diagnosis they do not wish to have.'

In an interview with ITV's This Morning programme last month Mr Cameron explained: 'Six months ago, I set up this challenge to say we’ve got to do better as a country in three vital regards. 

'First is how do we treat people with dementia in the health service, in care homes? In some cases it’s brilliant, in many cases it’s not good enough, and remember one in four hospital beds are occupied by someone with dementia.

'What more can we do in society to show understanding for people with dementia and make sure we treat them properly?

'Third, but I think almost the most vital, is putting more money into dementia research.

'I think there a lot of people out there who think dementia is just part of ageing, part of getting old. It isn’t. It’s a disease of the brain. We’ve got about 670,000 people with dementia, but tragically only 40 per cent - less than half - know they’ve got it. 

'We are not diagnosing it fast enough, we are not treating it fast enough. But there’s a really big cultural change we need to make. We know cancer is a killer that we want to get on top of.

'We need to think of dementia in the same way. This is a disease that we need to try and tackle with all our brains and brilliant scientists.'

Liverpool Care Pathway - A Tale Of Two Cities...?


The James family have suffered the loss of a husband, a father, grandfather and friend.

This is the tragic tale of another unexplained death in 2009, in Cosham, Portsmouth..

This is The News -


Husband still waiting for answers 
over wife's death
Grieving widower Rex Patterson launched a protest campaign after spending almost a year trying to find out why his wife died in hospital.
Thelma Patterson, 59, died two days after being admitted to Queen Alexandra Hospital in Cosham with a blood clot on the lung.
Mr Patterson says she was refused a scan that could have located the clot because the hospital did not operate the machines at the weekends. And he says medical staff left her even though they could not find a pulse or reading for her blood pressure.
The 61-year-old has written to the hospital 16 times since his wife's death on January 11. NHS guidelines say most complaints should be resolved within 25 days.
Mr Patterson says that on nine occasions his letters were ignored.
He has sent the order of service from his wife's funeral to the hospital on the 11th of every month to remind it of his case
And in a desperate bid for attention, this week he parked his wife's car, covered in the words 'Killed by medical neglect at QA Hospital', in the hospital car park.
'I have tried so hard to get answers', said Mr Patterson, a former police officer of Swanage Road, Lee-on-the-Solent. 'But I have just been ignored or told they're investigating and will be in contact, and then I've heard nothing. What else could I do to make them listen?'
Recalling the hours leading up to his wife's death, Mr Patterson said: 'She was told she'd need a scan to locate the clot. But then we were told she would have to wait until Monday as the machine wasn't operated over the weekend. All they did was put her on blood-thinning drugs.
'She was getting weaker and weaker. At one point she actually said to me "I'm going to die in here. They are not doing anything."'
Mr Patterson said a nurse checked his wife's blood pressure and pulse at 3pm on the day of her death. 'There was no reading for either. But the nurse just said "I will do it again later."
'Several more nurses tried over the next few hours and still got no reading. One even said "Maybe the machine's broken." I was pleading with them to call a doctor. I even said to them, "You are killing my wife.'"
A senior health official arrived about 6.45pm.
Mr Patterson said: 'They said they were treating her with a drug that would kill the clot but their concern was that she had been left too long and her body was too weak to recover.'
A cardiac team then arrived and at about 7.30pm Mrs Patterson died. A post-mortem examination revealed she died of a build- up of fluid on the lungs.
Mr Patterson said: 'I feel she was killed by negligence. She was left too long.'
Portsmouth Hospitals NHS Trust, which runs QA, said it had reviewed Mrs Patterson's case and her husband would now be invited to the hospital to discuss the findings.
Peter Mellor, the trust secretary, said: 'A thorough investigation has been carried out. Because the investigation needs to be thorough, it takes time.
'We recognise that the death of Mrs Patterson is a tragedy for which we are sorry. If we have not kept Mr Patterson as well informed about our progress I can only apologise for that. That is a shame on our behalf.'
VEHICLE COVERED WITH SHEET AND POLICE CALLED IN
In a desperate attempt to get hospital officials to give him answers about his wife's death, Rex Patterson parked his wife's Mini Cooper S outside Queen Alexandra Hospital, Cosham, on Monday.
He had put pictures of his wife, Thelma, on the car and slogans such as 'Killed by neglect at QA'.
The car was parked at the hospital from 7.30am and caused chaos at the front entrance.
Security guards could be seen covering the car in a white sheet, and a group of security men, later joined by police, were stationed around the vehicle throughout the morning.
A security car was also parked behind the vehicle, blocking one lane of the road and slowing traffic.
The car was being treated as a suspicious vehicle and so police were called.
Mr Patterson returned to his car at 11.30am. Health officials said the car was covered up to protect other patients. Peter Mellor, the secretary of Portsmouth Hospitals NHS Trust, which runs QA, said: 'I fully recognise that Mr Patterson is upset and distressed and I fully recognise his right to ask difficult questions, criticise, and we enjoy the freedom of speech in this country.
'However, putting up statements like that in view of other patients arriving at the hospital were likely to cause harassment, alarm and distress. This was not about covering anything up. It was about shielding patients.'
'SUCH A KIND WOMAN WITH SUCH A WIT'
Thelma Patterson had the ability to put a smile on the face of all those who knew her, husband Rex said.
She was a happy, popular and witty woman and a much-loved wife, mother and grandmother.
Her untimely death at just 59 has left an enormous void in her family's lives, especially Rex's, her life-long sweetheart.
The pair met when they were just children – Thelma aged three and Rex five. Both lived in Cherry Close, Lee-on-the-Solent.
As they grew up they went to the same school and started dating as teenagers, eventually marrying in 1969.
'She's the only woman who's ever been in my life,' said Mr Patterson, 61. 'I miss her. Everyone does.'
Mrs Patterson began working life as a bank worker. She then stopped working to have their children, Gary, now 38, and Clair, 36.
Before she died, she had been working as a doctors' receptionist at Lee Health Centre for six years.
'She was extremely popular,' said Mr Patterson. 'Even at work she had friends both sides of the counter.
'She had such a wit and would always make people smile. She was just so funny and had an infectious laugh. She loved her family and was such a kind person.'
Between 2006 and 2007, Mrs Patterson had a battle with breast cancer. Otherwise, she was a healthy and active woman.
She loved seeing her family and her granddaughter Jess, eight.
She also loved gardening and enjoyed nothing more than the passion she shared with her husband for Mini racing.
The pair would travel all over the country for race meetings and Mrs Patterson cherished her beloved Mini Cooper S.
TIMELINE – REX PATTERSON'S RECORD OF EVENTS
January 13 - Rex Patterson writes to Ursula Ward, the chief executive of Portsmouth Hospitals NHS Trust, which runs QA, requesting the complaints procedure.
January 16 - Receives a letter from a secretary at the hospital saying his letter had been forwarded to the head of legal services.
January 19 - Mr Patterson phones head of legal services Sue Skye and is told to write in, outlining his complaint.
January 20 - Mr Patterson sends a letter of complaint and a request for admission records.
January 23 - Receives a letter from hospital saying he cannot have the admission notes until after an investigation has been carried out.
January 27 - Receives a letter from Amanda Alder saying she has been appointed complaints officer for his case.
January 27 - Mr Patterson makes another request for admission records. Receives no reply.
February 9 - Mr Patterson writes to Ms Ward and Ms Skye pointing out his unanswered letter of January 27 and the records issue.
February 11 - Mr Patterson receives record notes but some are missing.
February 27 - A letter received from the complaints officer states the NHS guidelines of 25 working days to reply to a complaint could not be met. No extended timescale discussed.
March 12 - Mr Patterson writes to Ms Ward pointing out time limit for responding to a complaint had passed and there was no agreed 'extended timescale'.
March 17 - Mr Patterson writes to Ms Ward again as he had had no reply. Still no reply.
April 9 - Mr Patterson writes to Ms Ward saying that with the three months since his wife's death approaching he expects a reply by April 17 at the latest
April 18 - Mr Patterson receives a letter from Ms Ward. It says they could not identify the nurse who found Mrs Patterson had no measurable blood pressure or pulse and an investigation was on-going.
April 25 - Mr Patterson tries calling Ms Ward but cannot get hold of her. Mr Patterson then responds in writing. He says he would be happy to meet any time and asks for a fixed date for the final report. No reply.
May 19 - Mr Patterson again writes to Ms Ward for an estimated date for the final report and updates. No reply.
May 26 - Mr Patterson again writes to Ms Ward pointing out he had no replies and asks if the complaints department had a manager. Again, no reply.
May 29 - Receives a letter from Sheena King, head of risk management and legal services, saying his complaint was being reinvestigated by an independent healthcare professional under the trust's risk management processes.
June 3 - Mr Patterson replies to Ms King pointing out the lack of updates and incomplete admission notes. No reply.
June 9 - Mr Patterson writes again asking for admission notes.
June 24 - Notes received but no information on updates or final report.
July 10 - Mr Patterson e-mails Ms King, stating that six months have passed and there is still no report or regular update.
July 17 - A letter is received from the hospital saying a second draft of the report would be complete by the end of the week and Mr Patterson will be contacted.
August 11 - Mr Patterson e-mails Ms King to point out there has been no update or agreed date for the report. He also says he will display posters about his case at the hospital.
August 11 - E-mail asks Mr Patterson not to put up posters. He is told the report will be going to the serious incident review group in September for final sign-off and he will then be invited to a meeting. No news follows about the report or meeting.
September 11 - Mr Patterson sends a letter to Ms Ward pointing out it has been eight months and still no update. He receives no reply.
November 16 – Mr Patterson parks his dead wife's car at QA in protest and The News gets involved. The hospital then says it has completed its report and offers to meet Mr Patterson





























Liverpool Care Pathway - Whither Dignity In Living?


They are concerned with end-of-life care almost to the point of obsession.

How is that point determined with certainty? Professor Pullicino considers it not to be scientifically possible to diagnose dying and to predict death.

The assurances given that those placed on the Pathway may be removed from it should they improve serve only to confirm that wrong diagnoses of dying do occur.

Misdiagnosis is far from uncommon:
The statistics indicate as many as 9 million patients nationwide and between 400,000 and 528,000 patients in Illinois are harmed each year. According to Graber and other researchers, deaths and serious harm associated with diagnostic errors are uncommon even though an estimated 5 percent to 15 percent of medical diagnoses are incorrect. But for those harmed, Graber said the impact can be devastating.(Liverpool Care Pathway – Misdiagnosis, Misdiagnosis, Misdiagnosis) and
(Liverpool Care Pathway – And More Misdiagnosis)
But misdiagnosing dying can be fatal!

How many more, already frail and fragile, succumb to the rigours of the Pathway and fail to improve for that reason and perish on it?

And the new Death List guidelines for GPs actually advise them to use their intuition...?

This is Worcester News -

Plans over end-of-life care discussed

9:50am Thursday 3rd January 2013 in Local
EXPERTS from the NHS and hospices in Worcestershire have discussed the best ways to care for people towards the end of their lives.
The topic formed part of Worcestershire Health and Care NHS Trust’s second members’ event and featured a talk by Dr Ian Douglas, a consultant in palliative medicine.
Around 100 members including trust staff, staff from partner organisations and members of the public attended.
The audience was invited to speak to Dr Douglas and other professionals from different teams within the trust and from the Worcestershire hospices, general practice and Worcestershire Acute Hospitals NHS Trust.
They answered questions on the approach taken to supporting and caring for people during the final days or hours of their life.
The event coincided with the Government ordering a series of reviews into the Liverpool Care Pathway which was developed in the 1990s to guide health professionals in how to provide quality care during the final stages of someone’s life.
The pathway attracted criticism recently following complaints that it was being introduced for some patients without consent of or discussion with their families.
Dr Douglas said: “End of life care is a really big and live issue at the moment and it is something which is close to the hearts of professional, patients and their families.”
The event is the second held by the trust for its members, of which there are now over 11,000. To find out more and to complete a membership form visit worcestershirehealth.nhs.uk/whct-ft/ or contact 01905 681425.

Are there no 'Experts' from the NHS ready to come clean and have public discussions around 'Care of the Living' in NHS Hospitals?

All NHS patients deserve 'quality care', respect and 'dignity'. It is high time they received it!

Liverpool Care Pathway - Valid Comment

This is herald scotland -



THURSDAY 3 JANUARY 2013
pick a pathway, you're leaving
It must be these dark, post-festive days of the new year that set me thinking about the Liverpool Care Pathway for the Dying Patient.
The LCP, as it is known for short, is the guidebook for giving terminal cases a gentle nudge into eternity.
Patients for whom doctors consider nothing can be done are put on the pathway. Treatments and medication are discontinued. Clinicians are "prompted to consider whether clinically-assisted nutrition or hydration is needed and is in the person's best interests".
I worry when some doctors say patients are being put on the pathway unnecessarily. I worry when the NHS pays financial incentives to health trusts to get more patients on an accelerated road to death.
It is disconcerting to hear Jeremy Hunt, the Westminster Health Secretary, describe the Liverpool Care Pathway as "a fantastic step forward" in allowing death with dignity. The same Mr Hunt who as Culture Secretary thought it was a fantastic idea to hand control of almost all our TV to Rupert Murdoch.
The most shocking aspect (apart from hospital trusts getting bonuses for re-shuffling departures from this mortal coil) is that half the patients don't know they are on the pathway. Me, I would rather know if I was being pointed to the exit.
I will have to carry a card saying that in the event of imminent death I am not to be placed on the LPC. It will state my preference of going on a pathway which involves hydration (assisted if necessary) with the very best of red wines. With regular supplements of the finest brandies. Could the nurse peel me a grape ? And leave the oxygen mask off while I smoke a large Havana cigar?
In fact, the last few weeks have seemed to be a trial run of a pathway of death by indulgence. People have been trying to kill me all through the Christmas and New Year period. Truffles, Belgian chocolates, entire selection boxes all designed to trigger the Type 2 diabetes peripheral nephritis. Go on, have a drink and damage your liver. This large cheeseboard will only make you a teensy bit more obese.
PS: If you're looking for a pathway, avoid Shettleston. That's the one where on average you die 15 years younger than the folk who live in leafier and wealthier parts of the UK.
The spark of human decency is not yet extinguished...

Liverpool Care Pathway - This Is It


Yes, this really is the Liverpool Care Pathway.

This is This is Wiltshire -


This Is Wiltshire

Health boss defends GWH Pathway care

9:20am Thursday 3rd January 2013 in News


Musosa Kazembe, a distinguished journalist who died at the hospital a year ago after 
spending weeks on the Liverpool Care Pathway.

A PATHWAY scheme for terminally ill patients used by Great Western Hospital has been praised as “a fantastic step forward” by Health Secretary Jeremy Hunt.

The Pathway was criticised by the family of Musosa Kazembe, a distinguished journalist who died at the hospital a year ago after spending weeks on the regime.

A series of cases across the country in recent months have raised concern about the scheme, which is designed to ease the suffering of patients in their final days.

Mr Hunt said: “It’s a fantastic step forward, the Liverpool Care Pathway, and we need to be unabashed about that. It’s basically designed to bring hospice-style care to terminally-ill people in hospitals.

“Inevitably, people do die in hospitals but they weren’t getting the quality of care in those final few hours,” the Health Secretary added.

Mr Hunt told London LBC Radio that patients were given a “dignified” death without “lots of tubes going in and out of their body”.

The Pathway encourages the removal of medication, fluids and other treatments which are no longer beneficial, and the Great Western Hospital is one of more than 300 hospitals nationally that use the scheme.

Mr Hunt said: “The Liverpool Care Pathway was developed with Marie Curie, with Macmillan, with Age UK and a number of other charities to try to bring that dignity to people in their last moments.”

Mr Kazembe, who reported on the fight against racism across Africa and Europe, spent weeks on the Pathway and at one point woke up to ask for water.

Most patients are on the scheme for 33 hours before death. The 74-year-old’s family said he was only given one day’s medication, two days’ food and six days’ water.

The hospital has said it did its utmost to meet the family and provide them with information including medical records and to discuss their concerns.

According to information obtained under the Freedom of Information Act, the total number of deaths of patients on the pathway for 2010/11 and in 2012, there were 741 deaths and 201 of these were on the LCP. In 2011 there were 427 out of 1,296 and in 2010 there were 377 out of 1,248.

Between April and June 2011 inclusive, the average number of hours in which a person’s care was supported by the LCP before death was 27.

The Liverpool Care Pathway –

If it can happen to a journalist, it can happen to anybody.


Family in dispute with hospital over journalist’s death
The death of a former regional newspaper reporter who battled apartheid and once interviewed Enoch Powell has led to a dispute between his family and the hospital where he died.
Musosa Kazembe worked for the Swindon Advertiser in the 1970s and went on to work on various publications which saw him reporting from the front line of the fight against racism in Africa and Europe.
Following his death last week at the age of 74, his family gave an interview to the Advertiser in which they claimed he was condemned to die by Swindon’s Great Western Hospital.
Zimbabwean-born Musosa was in hospital for 28 days before his death. He had Parkinsons Disease and was believed to have been suffering from pneumonia.
His son Chim told the Advertiser his dad was left to ‘starve’ despite at one point being well enough to speak.
Reported on these pages here -

Liverpool Care Pathway – Compounding The Errors