The much-maligned Liverpool Care Pathway may still be the most effective means available to help nurses structure the specifics of end-of-life care, according to an expert in clinical ethics in this week’s Nursing Times.
It’s healthy to have this debate now about how much the LCP supported nurses and enabled them to think about how to ensure their patients had a “good death”, but given the respect with which the pathway is viewed by many - both in the UK and internationally - isn’t it strange that this challenge wasn’t verbalised enough earlier?
Once again, the media directed policy from a sensationalist perspective with little understanding of the LCP and support it offers to health professionals, patients and families when used properly. In replacing the LCP the baby was thrown out with the bath water to appease the hacks.
Our article by academic Anthony Wrigley on page 20 states that the LCP offers world-class guidance, but if you read the front pages of the newspapers and you’d probably feel the exact opposite.
“Whatever is true, it’s a shame the media perspective has clouded many people’s views of the guidance”
Whatever is true, it’s a shame the media perspective has clouded many people’s views of the guidance. Nurses can contribute many examples of best practice when using the LCP but instead it was dismissed as a pathway allowing no deviation. Of course, it was misused in some cases, but this is a training and support issue rather than a major flaw in the LCP.
The result of Neuberger’s review - Priorities for Care - shares one thing in common with the LCP - it has not been explained properly or rolled out consistently with formal training. What is lacking is consistency, and a commitment to supporting clinicians.
Confusion reigns supreme over what to do, mixed in with paranoia about implementing any kind of plan for fear of doing the wrong thing. This risks creating a void, the worst possible outcome for dying patients and their relatives.
If staff are following the LCP it is because they want something that specifically helps them to deliver the care they want to, and they need training in how to apply the guidance with compassion.
Months after the LCP was deemed unworkable, concerns have been raised that there is still no viable replacement. Isn’t it time there was? Isn’t it time to commit to getting this right by giving nurses and patients what they actually want and need?
Jenni Middleton, editor
email@example.com. Follow me on Twitter @nursingtimesed