Death pathway 'should be phased out'

Written By Unknown on Sabtu, 13 Juli 2013 | 15.36

13 July 2013 Last updated at 04:22 ET

The Liverpool Care Pathway, developed to support patients as they near death, should be phased out in England, an independent review is expected to say.

The system can involve withdrawal of medication, food and fluids.

It can offer a peaceful and dignified death but there have been problems with its implementation, the government-commissioned review is set to say.

Health officials said the review was expected to recommend the LCP should be phased out within six to 12 months.

'Worrying standards'

The system was developed at the Royal Liverpool University Hospital and the city's Marie Curie hospice in the 1990s to provide a model of best practice in the care of dying patients.

It can mean an end to invasive tests, treatment or feeding through tubes that is deemed to cause unnecessary suffering at the end of life - but it should be discussed with the patient, family or carer where possible.

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We need a new system of better end-of-life care tailored to the needs of individual patients and involving their families"

End Quote Norman Lamb Care Minister

The Department of Health in England set up an independent review amid fears the LCP was being used to hasten death, to clear beds and save money, and that patients or their families were not being consulted.

The review, led by crossbench peer Baroness Julia Neuberger, applies only to England although the LCP is used across the UK.

It was asked to focus on the use of the LCP model rather than re-evaluating its basic merits.

But officials said the review team, which heard evidence from patients, families and health professionals, encountered "numerous examples of poor implementation and worrying standards in care".

The review was likely to conclude it needed to be replaced.

A Department of Health spokesman said: "The independent review into end of life care system the Liverpool Care Pathway, commissioned last year by Care and Support Minister Norman Lamb and backed by Health Secretary Jeremy Hunt, is likely to recommend that the LCP is phased out over the next six to 12 months."

The statement gave no indication of what might replace the LCP.

But Mr Lamb told the Daily Telegraph: "We need a new system of better end-of-life care tailored to the needs of individual patients and involving their families."

'Unacceptable cases'

He ordered the review in November last year amid intense media scrutiny of the LCP following criticism from patients' families.

At the time, he said he was concerned about the "unacceptable" cases that had come to light.

Mr Lamb told the Saturday's Telegraph: "We took those concerns very seriously and decided that we needed to establish the facts of what was happening so we could act where needed."

Last month members of the British Medical Association said patients may have been put on the LCP when it was not appropriate because hospitals were offered financial incentives to use it.

The review's findings are due to be published in full on Monday.


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