The Liverpool Care Pathway (LCP) is set to be abolished after an independent review found that the scheme was being used by doctors “as an excuse for poor quality care”.
The review, headed by crossbench peer Baroness Julia Neuberger, concluded that the controversial regime should be axed within 12 months and replaced by personalised care plans for individual patients.
The LCP was set up at the Royal Liverpool University Hospital and the city's Marie Curie hospice in the 1990 to care for and relieve the suffering of patients who are reaching the end of their lives.
Under fire
But the scheme came under fire last year after it was claimed that doctors were using it to hasten death, save money and clear hospital beds. There were also reports of food and hydration being withdrawn from dying patients without the knowledge and consent of their loved ones.
A review was subsequently commissioned into the use of the scheme by Care and Support Minister Norman Lamb in November, who said he was concerned about the “unacceptable cases” that had emerged.
Tick box exercise
The review, which heard evidence from patients, family members and health professionals, found that while the regime could offer “high quality and compassionate care", it had been applied incorrectly in “too many cases” and had been reduced to a “tickbox exercise."
It noted instances where dying patients had been deprived of water and placed on the pathway without their loved ones being told that they were expected to die.
Junior doctors had been required to make serious decisions without the necessary expertise, and nurses sometimes lacked compassion when dealing with those placed on the pathway and their family members.
Misused
Baroness Neuberger said: “Ultimately it is the way the LCP has been misused and misunderstood that had led to such great problems.
“Caring for the dying must never again be practised as a tickbox exercise and each patient must be cared for according to their individual needs and preferences, with those of their relatives or carers being considered too."
The review recommended that the LCP should be phased out “over the next 6 to 12 months” and replaced by personalised end of life care plans “backed up by good practice guidance specific to disease groups.”
Mr Lamb said: “We hope the actions we have taken today will reassure patients and their families that everyone coming to the end of their life is getting the best possible care and that concerns are being dealt with swiftly.
Slavishly
“I have personally heard families describe staff slavishly following a process without care or compassion and leaving people suffering at the end of their lives. This is something we cannot allow to go on.
"People's final days should be as comfortable and dignified as possible. That is why there is a place for thoughtful and careful end-of-life care that involves patients and their families, but it is clear what we have now needs to be replaced so we can create a better way of doing this.”
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