Adam Gretton, Health correspondent
Friday, May 30, 2014
Significant strides have been made in improving end of life care across Norfolk after the government scrapped the controversial Liverpool Care Pathway (LCP), health chiefs said yesterday.
Officials from the three acute hospitals in Norfolk said they were developing more personalised plans for dying patients after phasing out the “discredited” palliative care programme following an independent report into the practice.
However, experts told members of the Norfolk Health Overview and Scrutiny Committee that there was uncertainty over the future of end of life care and NHS trusts were still awaiting official guidelines from a Leadership Alliance for the Centre of Dying People report.
LCP, which was developed in the 1990s, was intended to allow people with a terminal illness to die with dignity. However, there have been number of high-profile stories across the country of people being placed on the pathway and having medication, food and liquids withdrawn without consent or their family’s knowledge. Concerns were also raised that hospitals were receiving incentive payments for putting patients on LCP.
The government recommended last July that the practice should be phased out following a review by Baroness Julia Neuberger.
Senior managers at the Norfolk and Norwich University Hospital, James Paget University Hospital in Gorleston, and Queen Elizabeth Hospital in King’s Lynn yesterday said that LCP had been completely stopped since the recommendations were made for more individual care plans.
However, Norfolk Community Health and Care will officially scrap the pathway on June 1.
Katie Soden, lead consultant at NCH&C’s Priscilla Bacon Centre, said the specialist palliative care site in Norwich had not been using LCP for a number of months and were developing individual care plans.
“It has become clear there will be no care pathway to replace LCP. We are waiting for the outcome of a national report, but there is no confusion about good end of life care with patients at the heart of that and with families in mind.”
“When it [July’s report] was published there was guidance that it should not be stopped abruptly. LCP was national best practice and its principles are what we all aspire to and are held to be good by many professionals. The way it was used was the problem.
“The guidance was to withdraw it over 12 months and we have put that in place,” she said.
The committee heard that hospitals had attempted to improve standards by ensuring a named senior clinician is responsible for an individual patient’s care. Officials added that they were working together to integrate care and develop a single yellow folder across Norfolk stating a person’s wishes for their end of life care and piloting electronic palliative care records.
Elizabeth Libiszewski, director of nursing, quality and patient experience at the JPH, added: “We have responded to a national outcry to something that is misconstrued and ill applied. We have not waited a year - we took very urgent steps to move away from something that had become a problem in the public’s eyes.”
Committee member Margaret Somerville added that she was “extremely impressed” with the work to improve palliative care and “coordination and integration is absolutely vital.”
However Tony Wright said: “I think there is a danger that you are doing the same thing under a different name and I get the feeling that we need a clearer picture.”
What are your family’s experiences of end of life care? Email firstname.lastname@example.org