End of life care to be overhauled
There should be an overhaul inside the way dying patients are cared for in England, ministers have conceded.
The government has ordered hospitals to hold out immediate reviews in their practices and announced the Liverpool Care Pathway might be phased out.
It comes after an independent report concluded the pathway, which is able to involve the withdrawal of food and treatment, was being “misused”.
It can be replaced by individual end of life care plans within a year.
These plans could be tailored take into consideration different conditions.
One of the key criticisms of the independent review – chaired by crossbench peer Baroness Julia Neuberger – was that the LCP had become a “tick box” exercise, which failed to take the person patients’ circumstances into consideration.
The Care Quality Commission, which regulates hospitals, has also been told to guarantee end of life care becomes a more important component to the inspection regime.
Care and Support Minister Norman Lamb said: “We are hoping the actions we’ve taken today will reassure patients and their families that everybody coming to the tip in their life is getting the absolute best care and that concerns are being handled swiftly.
“I actually have personally heard families describe staff slavishly following a process without care or compassion and leaving people suffering on the end in their lives. Here is something we can’t allow to move on.
“People’s final days must be as comfortable and dignified as possible. For this reason there’s a place for thoughtful and careful end of life care that involves patients and their families, however it is obvious what we now have has to be replaced in order to create a smarter way of doing this.”
The review was installation on the turn of the year amid concerns with the manner the LCP was getting used and the truth that hospitals were being financially incentivised to apply it.
The LCP is suggested as best practice in Scotland and northerly Ireland in addition to England. Wales has its own system.
The review, which took evidence from patients and health staff in addition to reviewing literature, said a “deeply distressing” picture had emerged.
It described patients being left without adequate nutrition and hydration with reports of patients desperately attempting to suck sponges utilized by staff to dab their faces.
The experiences of several families were included inside the review’s report – lots of which concerned the wrong denial of fluids.
One said: “We were told that if we would have liked anything to drink then the only real way can be fore the family to soak a paper towel from the dispenser int he toilet and let her suck it.”
But the review also said they’d found evidence that after the LCP was used correctly and in consultation with the patient and their relatives it may help ease death.
Nonetheless, Baroness Neuberger said the LCP needed to be phased out as there have been now simply too many unacceptable cases to “turn the clock back” and get it used properly be everybody.