Liverpool Care Pathway to face independent scrutiny, says Lamb
A series of reviews into the Liverpool Care Pathway for end of life care patients will be overseen by an independent chair, the government has announced.
Three separate reviews of end of life care are currently being carried out by the Association of Palliative Medicine, the Dying Matters group and the National End of Life Care Programme.
Health minister Norman Lamb yesterday announced that an independent chair would be appointed to oversee the three reviews.
Mr Lamb’s intervention follows ongoing negative press coverage surrounding the Liverpool Care Pathway, which has persisted despite efforts by clinicians and palliative care organisations to defend the pathway when implemented correctly.
In particular, there have been stories regarding patients being put on the pathway without the knowledge of their relatives and, more recently, claims that trusts are putting too many patients on the pathway in order to meet targets linked to payments.
Mr Lamb said: “It is clear that everyone wants their loved ones’ final hours of life to be as pain free and dignified as possible, and the Liverpool Care Pathway is an important part of achieving this aim.
“However, as we have seen, there have been too many cases where patients were put on the pathway without a proper explanation or their families being involved. This is simply unacceptable.
“I have committed to appoint an independent chair to review how end of life care is working and oversee the reviews into the LCP. This will report back to me in the New Year.”
He added that work would also be undertaken to “consider the value of locally set incentives and whether they are leading to bad decisions or practice”.
“It is vitally important that everyone can be confident in the findings of this work – and that we learn lessons where they are needed, so we can ensure that end of life care is as good as it can be,” he said.
Mr Lamb made the announcement after attending a roundtable meeting yesterday with stakeholder groups.
He added: “Care for the dying is an emotive issue and is never an easy subject to discuss. I am grateful to those who attended the roundtable and shared their views and experiences with me this afternoon.”
Groups attending the meeting included the Marie Cure Palliative Care Institute Liverpool, which brings together the academic and NHS organisations that originally developed the pathway.
Professor John Ellershaw, the institute’s director and national clinical lead for the LCP, told the meeting: “The Liverpool Care Pathway and its use have been misrepresented in some sections of the media in a way that is unhelpful to improving care for people at the very end of their lives. It has fed on the fear of death in society.
“The LCP provides focus for care in the last hours or days of life but the vital communication, care and compassion required in those days and hours come from those caring for the patient and their family.”
The National End of Life Care Programme also attended the meeting. Its director Claire Henry said: “We were pleased to contribute to an informed debate on how improvements can continue to be made.”
She added: “We strongly welcome the minister’s announcement of an independent chair to help deliver these reviews. This is crucial if the findings are to be viewed credible by all.
“A main priority is to ensure that this work is undertaken transparently. We look forward to working with the appointed chair to publish findings in the New Year.”
The government announced earlier this month that rules in the NHS Constitution on involving individuals and families in treatment decisions would be strengthened.
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