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| Liverpool Care Pathway 'should be phased out' | Liverpool Care Pathway 'should be phased out' |
| (about 1 hour later) | |
| The Liverpool Care Pathway, developed to support patients as they near death, should be phased out in England, an independent review is expected to say. | The Liverpool Care Pathway, developed to support patients as they near death, should be phased out in England, an independent review is expected to say. |
| The system can involve withdrawal of medication, food and fluids. | The system can involve withdrawal of medication, food and fluids. |
| It can offer a peaceful and dignified death but there have been problems with its implementation, the government-commissioned review is set to say. | It can offer a peaceful and dignified death but there have been problems with its implementation, the government-commissioned review is set to say. |
| Health officials said the review was expected to recommend the LCP should be phased out within six to 12 months. | Health officials said the review was expected to recommend the LCP should be phased out within six to 12 months. |
| 'Worrying standards' | 'Worrying standards' |
| The system was developed at the Royal Liverpool University Hospital and the city's Marie Curie hospice in the 1990s to provide a model of best practice in the care of dying patients. | The system was developed at the Royal Liverpool University Hospital and the city's Marie Curie hospice in the 1990s to provide a model of best practice in the care of dying patients. |
| It can mean an end to invasive tests, treatment or feeding through tubes that is deemed to cause unnecessary suffering at the end of life - but it should be discussed with the patient, family or carer where possible. | It can mean an end to invasive tests, treatment or feeding through tubes that is deemed to cause unnecessary suffering at the end of life - but it should be discussed with the patient, family or carer where possible. |
| The Department of Health in England set up an independent review amid fears the LCP was being used to hasten death, to clear beds and save money, and that patients or their families were not being consulted. | The Department of Health in England set up an independent review amid fears the LCP was being used to hasten death, to clear beds and save money, and that patients or their families were not being consulted. |
| The review, led by crossbench peer Baroness Julia Neuberger, applies only to England. The LCP is also used in Scotland and Northern Ireland but not in Wales, which has its own framework for end-of-life care and support. | |
| The review for England was asked to focus on the use of the LCP model rather than re-evaluating its basic merits. | |
| But officials said the review team, which heard evidence from patients, families and health professionals, encountered "numerous examples of poor implementation and worrying standards in care". | But officials said the review team, which heard evidence from patients, families and health professionals, encountered "numerous examples of poor implementation and worrying standards in care". |
| The review was likely to conclude it needed to be replaced. | The review was likely to conclude it needed to be replaced. |
| A Department of Health spokesman said: "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 six to 12 months." | A Department of Health spokesman said: "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 six to 12 months." |
| The statement gave no indication of what might replace the LCP. | The statement gave no indication of what might replace the LCP. |
| But Mr Lamb told the Daily Telegraph: "We need a new system of better end-of-life care tailored to the needs of individual patients and involving their families." | But Mr Lamb told the Daily Telegraph: "We need a new system of better end-of-life care tailored to the needs of individual patients and involving their families." |
| 'Unacceptable cases' | 'Unacceptable cases' |
| He ordered the review in November last year amid intense media scrutiny of the LCP following criticism from patients' families. | He ordered the review in November last year amid intense media scrutiny of the LCP following criticism from patients' families. |
| At the time, he said he was concerned about the "unacceptable" cases that had come to light. | At the time, he said he was concerned about the "unacceptable" cases that had come to light. |
| Mr Lamb told Saturday's Telegraph: "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." | Mr Lamb told Saturday's Telegraph: "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." |
| British Medical Association president elect Baroness Finlay said the LCP was originally brought in because patients were "dying badly, in hospitals in particular". | 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". | 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. | "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. |
| She said that if the LCP was phased out it was vital something better replaced it. | She said that if the LCP was phased out it was vital something better replaced it. |
| "Something which is very clear, very simple and which drives up professional behaviour and stops the 'routine-isation' of something for each patient... their individual needs and care priorities must be looked at," Baroness Finlay added. | "Something which is very clear, very simple and which drives up professional behaviour and stops the 'routine-isation' of something for each patient... their individual needs and care priorities must be looked at," Baroness Finlay added. |
| Jason Suckley, director of policy and campaigns at Sue Ryder, said the healthcare charity's research had shown the timing and quality of conversations health professionals had with terminally-ill patients amounted to a "lottery". | Jason Suckley, director of policy and campaigns at Sue Ryder, said the healthcare charity's research had shown the timing and quality of conversations health professionals had with terminally-ill patients amounted to a "lottery". |
| He said workers' communication skills needed to be improved and urged Health Education England, which provides training and support for healthcare professionals, to include end-of-life training in its workforce mandate. | He said workers' communication skills needed to be improved and urged Health Education England, which provides training and support for healthcare professionals, to include end-of-life training in its workforce mandate. |
| "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," he said. | "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," he said. |
| The review's findings are due to be published in full on Monday. | The review's findings are due to be published in full on Monday. |