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Does your organisation have a replacement for the Liverpool Care Pathway?

  • Comments (5)

A recent news story in Nursing Times highlighted the views of the ethicist Dr Anthony Wrigley who suggested that axing the Liverpool Care Pathway (LCP) was “too extreme”. He said scrapping the measure on the basis of some poor use was like prohibiting the use of morphine.

It is generally accepted that there were problems with its implementation, but what will fill the gap when the pathway is phased out?

 

What do you think?

  • Does your organisation have plans to replace it?
  • Have you had training and education to manage palliative care without the LCP?
  • What help do you need to provide effective palliative care?
  • Comments (5)

Readers' comments (5)

  • Anonymous

    The people and the "gutter press" have had their say and got their wish!

    All dying patients will now be fed McD,s and will be forced to drink !

    Whilst not doubting that there were some instances of the LCP being poorly implemented the decision to abandon the LCP was a poorly thought out decision.

    The LCP was (and remains) the gold standard of palliative care , but sadly no more !

    I only hope that when my time arrives a very brave clinician will afford me the comfort of the LCP.

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  • Anonymous

    how will loved ones respond when they come along and find their relatives choking on McDos, chips and drinks?

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  • Anonymous

    Why don't they re-name it - 'The Loving Care Pathway'

    With better education about how to explain the ethos to patients and families

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  • Anonymous

    Anonymous | 3-Jun-2014 1:42 pm

    excellent, it would probably change the whole attitude of those who have been swayed by the media against it.

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  • michael stone

    I am bothered by what happens after the LCP has gone - but so far we don't know exactly what the LCP Replacement Team being lead by Bee Wee is going to come up with.

    I will need to see exactly what Bee comes up with re the Personal Palliative Care Plan (proposed name of 'the thing'), and then I would need details of what is actually happening 'on the ground', before I could comment.

    It wasn't the effectiveness or otherwise of the clinical treatments, that was so problematic with the LCP: what caused the problems were issues over both non-communication, and 'decision-making authority'. The decision-making and authority aspects are actually related to the Mental Capacity Act, and a recent House of Lords select committee report into the [non] implementation of the MCA made clear how unsatisfactory current understanding of, and behaviour 'around', the MCA is:

    http://www.publications.parliament.uk/pa/ld201314/ldselect/ldmentalcap/139/13902.htm


    The belief that really needs knocking on the head, is the idea that the law says [for mentally-incapable patients] that 'the clinicians consult with the family, but ultimately the clincians make the decisions' - that isn't what the law seems to say, if you read the law without assuming that to be true:

    http://www.bmj.com/content/348/bmj.g2043/rr/700882

    There is also a 'release' by a judge, which gets very interesting about half-way through (this looks very much like a 'short lecture in what the MCA actually means', in so far as it goes) and is very well worth a read:

    http://www.bailii.org/ew/cases/EWCOP/2014/4.html

    For example, sections 25, 26, 36, 53 and 55: but I suggest that anyone interested in the MCA and 'best interests' should read it all.

    It is the comments by nurses on this website, that have made me worry that 'throwing out the paperwork aspect of the LCP' will be very problematic - I like proper behaviour based on good training and understanding [of both medicine and law] but I am very bothered, that while the LCP was being imperfectly used in too many instances, without that 'formal structure' things will become worse. They need not get worse - the LCP could never have justified poor or good behaviour, so its removal cannot either, and it was only ever an attempt to 'somehow explain/impart expert behaviour to the less expert' - but I am concerned that things will get worse !

    What would probably have made the LCP work properly, would have been if welfare attorneys were common instead of rare: sadly, welfare attorneys are still very rare.


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