End of life care to be overhauled

Written By Unknown on Senin, 15 Juli 2013 | 19.12

15 July 2013 Last updated at 07:01 ET By Nick Triggle Health correspondent, BBC News
Norman Lamb MP

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Social Care Minister Norman Lamb "There has to be a more personal approach"

There needs to be an overhaul in the way dying patients are cared for in England, ministers have conceded.

The government has ordered hospitals to carry out immediate reviews of their practices and announced the Liverpool Care Pathway will be phased out.

It comes after an independent report concluded the pathway, which can involve the withdrawal of food and treatment, was being "misused".

It will be replaced by individual end of life care plans within a year.

These plans will be tailored to take into account different conditions.

One of the major criticisms of the independent review - chaired by crossbench peer Baroness Julia Neuberger - was that the LCP had become a "tick box" exercise, which did not take the individual patients' circumstances into account.

The Care Quality Commission, which regulates hospitals, has also been told to ensure end of life care becomes a more important component of the inspection regime.

'Deeply distressing'

Care and Support Minister Norman 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.

"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."

The review was set up at the turn of the year amid concerns with the way the LCP was being used and the fact that hospitals were being financially incentivised to use it.

The LCP is recommended as best practice in Scotland and Northern Ireland as well as England. Wales has its own system.

The review, which took evidence from patients and health staff as well as reviewing literature, said a "deeply distressing" picture had emerged.

It described patients being left without adequate nutrition and hydration with reports of patients desperately trying to suck sponges used by staff to dab their faces.

The experiences of several families were included in the review's report - many of which concerned the incorrect denial of fluids.

One said: "We were told that if we wanted anything to drink then the only way would 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 had found evidence that when the LCP was used correctly and in consultation with the patient and their relatives it could help ease death.

Nonetheless, Baroness Neuberger said the LCP had to be phased out as there were now just too many unacceptable cases to "turn the clock back" and get it used properly be everybody.


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