27.11.12
Liverpool Care Pathway review launched
An independent review is being launched into the Liverpool Care Pathway (LCP), following weeks of negative stories in the media.
The pathway, which sees medics withdraw treatment in the last few days of life, is aimed at reducing unnecessary interventions and improving people’s last few days. But it has faced much criticism in recent weeks, with claims that some hospitals are abusing the pathway, not consulting relatives adequately, or even seeking to gain financially from so-called ‘targets’ associated with LCP, which are in fact designed to support the implementation of better care.
Care minister Norman Lamb (pictured above) has announced the new review, which will consider the value of locally set incentives. An independent chair will be appointed to report back in the new year and the review will draw together data from other investigations currently being undertaken by the Association for Palliative Medicine, Dying Matters and the national End of Life Care Strategy.
Following a roundtable discussing the issue, Lamb said: “Care for the dying is an emotive issue and is never an easy subject to discuss. It is clear that everyone wants their loved ones' final hours of life to be as pain free and dignified as possible, and the Liverpool Care Pathway is an important part of achieving this aim.
“However, as we have seen, there have been too many cases where patients were put on the pathway without a proper explanation or their families being involved. This is simply unacceptable.
“Today I have committed to appoint an independent chair to review how end-of-life care is working and oversee the reviews into the LCP. This will report back to me in the new year.
“It is vitally important that everyone can be confident in the findings of this work – and that we learn lessons where they are needed, so we can ensure that end-of-life care is as good as it can be.”
The LCP, developed in the 1990s at the Royal Liverpool University Hospital and the Marie Curie Palliative Care Institute, is aimed at reproducing the excellent levels of care received in people’s final days in hospices into other settings, such as hospitals and care homes. Its goal is to ensure people have as dignified, comfortable and peaceful death as possible.
It is recommended as best practice by the Department of Health, and many health professionals have said the cases identified in recent weeks are the results of failures by individual clinicians and organisations, not an inherent fault of the LCP, which prioritises communication with families and judging all decisions on a case-by-case basis.
Claire Henry, director of the National End of Life Care Programme, said: “The minister’s roundtable provided a great opportunity to discuss care in the last days of life in a constructive way. We were pleased to contribute to an informed debate on how improvements can continue to be made.
“We were able to update on the work we’re co-ordinating to learn from people’s experiences and we strongly welcome the minister’s announcement of an independent chair to help deliver these reviews. This is crucial if the findings are to be viewed credibly by all.
“A main priority is to ensure that this work is undertaken transparently. We look forward to working with the appointed chair to publish findings in the new year.”
Last night’s BBC Newsnight included a discussion on the LCP, with input from Lamb. It can be seen here.
(Image of Norman Lamb courtesy bisgovuk, used here under a Creative Commons licence, some rights reserved.)
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