Did the Liverpool Care Pathway really need to be demolished?

Since the controversy over the now demolished Liverpool Care Pathway and a new approach to end of life care was announced in June by the Department of Health, the Commons’ health select committee has launched an inquiry into the whole system. They are examining the palliative and end of life care including what changes and improvements need to be made in all areas. But does this care plan need to be investigated or was it just the Liverpool Care Pathway being misread?

Sally Cliff, who was once a Palliative Care Lead Nurse, now a Deputy Ward Manager at Malton Hospital, said: “I think the public don’t have a clear understanding of what palliative care is about.”

The Liverpool Care Pathway, LCP, was a generic approach to care for the dying that ensured care was given to everyone, who was thought to be dying, in their last hours. However because of the criticism in the media and complaints made by relatives and the public, the LCP has now been removed.

Cliff believed the complaints made by relatives were because of the lack of communication between them and the staff, she said: “If there was communication between the relatives and staff, then we wouldn’t have had these complaints.”

Marie Lewis, another Nurse from the North Yorkshire Hospital, said the lack of communication was from healthcare professionals and doctors not explaining it properly – “A tool is only good if the people who are using it understand how to use it.”

Cliff said the LCP did work well at Malton Hospital. If a patient was on the LCP, they would be reviewed every three days and if a patient was improving then they would be taken off the care plan.

The LCP did not mean the patient was left for dead like all the negative articles in the papers were saying.

Lewis said: “The media doesn’t help because they always tend to pick up on the bad points when it’s used for the good so the public misunderstands the use of the care-plan.”

Like Cliff explained some relatives were distressed because nurses will not resuscitate when a terminally ill patient’s heart stops as they believe it’s their time to go with dignity. To the papers, this would be turned into a negative article about the care-plan.

But Cliff said before using the care-plan, the nurses would rule out any other illness which they could treat before putting the patient on the pathway as they would only be on the care-plan if terminally ill.

Also, as Cliff is on the National Gold Standards Framework team, GSF, she hears all the discussions revolving around palliative and end of life care including how to improve the quality of care so it leads to better outcomes for their patients.

The latest news from the GSF meetings is that the new care-plan guidelines for the palliative and end of life care are now available for nurses around the UK.

However Cliff has informed us the guidelines are similar to the Liverpool Care Pathway but with a few differences and with a new name of “Last Days of Life pathway”. These guidelines are yet to be put into action so it is unsure whether this care-plan works better than the LCP or will it gain a just as bad reputation?

Ends (550 words)

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