New alliance to lead drawing up of end-of-life care guidance
The government is expected to announce a new coalition on end-of-life care in response to the scrapping of the Liverpool Care Pathway (LCP).
The Leadership Alliance for the Care of Dying People will bring together health and social care groups with the aim of improving care for people at the end of their lives.
It comes after it was announced last month that the LCP will be axed, following an independent review sparked by increasing criticism of the pathway and how it was being used in the national media.
The announcement of a new coalition is expected to be made by NHS England.
In a statement, NHS England said the independent review had called for a coalition “to lead the way in creating and delivering the knowledge base, the education, training and skills and the long-term commitment needed to make high quality care for dying patients a reality, not just an ambition”.
The new alliance will be chaired by Dr Bee Wee, national clinical director for end of life care at NHS England.
The Care Quality Commission, the Department of Health, the National Institute for Health and Care Excellence, and the Nursing and Midwifery Council are among those who have signed up to the alliance.
The alliance will provide guidance on what needs to occur in place of the LCP and will work with end-of-life healthcare professionals, patients and families on what good care means.
It will also consider how to implement recommendations around the accountability and responsibility of individual clinicians, out-of-hours decisions, nutrition and hydration and communication with the patient and their relatives or carers.
The independent review concluded doctors had used the LCP - which recommends the withdrawal of treatment, food and water from some sedated patients in their final hours or days - “as an excuse for poor-quality care”.
The review panel, chaired by crossbench peer Baroness Julia Neuberger, said they were “shocked” and “upset” at some of the “distressing” cases of appalling care they had heard about.
Patients were left on the pathway for weeks without any review and some patients’ families claimed they were shouted at by nursing staff for giving their relatives water.
“The same stories keep emerging of poor care, appalling communications and of a lack of attention or compassion,” Baroness Neuberger said as she published her review.
“Among the worst stories were of people on the Liverpool Care Pathway for days going into weeks without communication or review or discussion.
“And also desperate stories of desperate people who are longing for a drink of water who were, through misunderstanding of the Liverpool Care Pathway and poor care, denied a drink,” she said.
“Stories of nurses shouting at families who give a patient a drink were frequent as were stories of people who were just left to get on with it with no regular observations or review,” she added.
In response, care and support minister Norman Lamb ordered all NHS hospitals to undertake reviews of care given to dying patients.
He also ordered hospital bosses to ensure that in the future every patient has a named senior clinician responsible for their care in their final hours and days of life.
Financial incentives to put people on the regime would also be scrapped, he added.
John Hughes, medical director at Sue Ryder, said: “We welcome the Leadership Alliance for the Care of Dying People, which was set up in response to the independent review of the Liverpool Care Pathway.
“The range of organisations included in the group from across health and social care highlights the importance of the issue, as well as the need for a united front to work towards improving the care for people facing the end of their lives.”
He added: “We’re keen to work with the LACDP, and are supporting a series of workshops to elicit the views from frontline palliative care professionals on what good end of care looks like regardless of the care setting.”
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