Liverpool Care Pathway, Controversial NHS End-Of-Life Care, 'To Be Phased Out'

Controversial End-Of-Life Care 'Should Be Scrapped'

An independent review of a controversial end-of-life regime is likely to recommend that it is phased out, it has emerged.

The review of the the Liverpool Care Pathway (LCP), chaired by crossbench peer Baroness Julia Neuberger, has been hearing evidence from patients, families and health professionals.

The LCP - which recommends that in some circumstances doctors withdraw treatment, food and water from sedated patients in their final days - has come under intense scrutiny.

A review into a controversial end-of-life regime is likely to recommend that it is phased out

Reports have suggested that doctors have been establishing ''death lists'' of patients to be put on the pathway.

Articles have also claimed hospitals might be employing the method to cut costs and save bed spaces.

But medics have argued that the pathway has ''transformed'' end-of-life care, saying it can offer peaceful, pain-free deaths when used properly.

A Department of Health spokeswoman said last night: "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 6 to 12 months.

"The review panel, set up by ministers following reports from families concerned about the care of their loved ones, is due to report back on Monday.

"It is expected to say that when used properly the LCP can give people a dignified and peaceful death, but that they found numerous examples of poor implementation and worrying standards in care which mean it needs to be replaced."

Lamb told the Daily Telegraph: "I took the decision to launch this review because concerns were raised with me about how patients were being cared for and how families were being treated during this difficult and sensitive time.

"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."

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

British Medical Association president elect Baroness Finlay said the LCP was originally brought in because patients were "dying badly, in hospitals in particular".

They were being "walked past, ignored and neglected", she said, and the LCP was an attempt to "roll out the best of hospice care into other areas".

"By and large that worked well but the problem has been that it hasn't always been used properly," she told BBC Radio 4's Today Programme.

Jason Suckley, Director of Policy and Campaigns at healthcare charity, at Sue Ryder said: "Sue Ryder has previously emphasised that although the LCP, and other integrated care pathways can be a successful way of delivering high quality and personalised end of life care, this is dependent upon whether or not the professionals using these pathways have received adequate training in end of life care.

"Given the expected recommendation of the Neuberger review to phase out the use of the LCP we call on Government to retain the elements of care that are essential to delivering good quality end of life care in any future guidelines for end of life care.

"We want to ensure that there is constant communication with those nearing the end of their life and their relatives about their preferences, treatment and dying.

"This includes meeting the social, psychological and spiritual needs of individuals and families which is the cornerstone of specialist palliative care that has developed in the hospice sector.

"We are clear that more needs to be done to improve the communication skills of healthcare professionals. This is evident from recent research that we have conducted with think-tank Demos around our campaign 'Dying isn't working' which revealed that there is a lottery regarding the timing and quality of conversations that GPs and other professionals have with individuals who are at the end of their life.

"This inconsistency means that many people are unable to prepare in advance and express their preferences about the death that they want. To make this happen we strongly feel that Health Education England must include end of life training in its workforce mandate, it is currently excluded.

"When it comes to dying we cannot afford to get it wrong and health professionals need to be supported to communicate with people effectively at a very traumatic and emotionally difficult time."

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