The end of the Liverpool Care Pathway for end of life care?
The Liverpool Care Pathway was developed during the late 1990s at the Royal Liverpool University Hospital, in conjunction with the Marie Curie Palliative Care Institute. It was intended to provide the best quality of care possible for dying patients in the last hours and days of life, whether they were in hospital, at home, in a care home or in a hospice.
The Liverpool Care Pathway deals with the spectrum of care provided to people at the end of their life. This includes consideration of whether further medications and tests should be undertaken, how to keep the patient as comfortable as possible, whether fluids should be given, when a patient has stopped being able to eat or drink and the patient’s spiritual or religious needs. In this way the Liverpool Care Pathway will often involve the withdrawal of food and treatment.
An independent review into end of life care (chaired by Baroness Julia Neuberger) has criticised end of life care advising that the Liverpool Care Pathway had become a “tick box” exercise. The review heard from many families who believe that their dying relatives had been left without adequate nutrition and hydration and that there had been an incorrect denial of fluids in some cases.
The review committee did not suggest that medical professionals should not be allowed to intervene with end of life care, only that how people are looked after in the final days of life should be a “core business” for hospitals.
The review found that when families were properly consulted and the Liverpool Care Pathway was used correctly it could help ease the dying process. Nonetheless, Baroness Neuberger concluded that there had simply been too many cases where dying patients had been provided with unacceptable levels of care and therefore a change had to be implemented.
Ministers have now conceded that there needs to be an overhaul in the way dying patients are cared for in England and the government has announced that the Liverpool Care Pathway will be phased out and replaced with individual end of life plans within the next year.
If you have concerns regarding poor treatment provided to a relative in their final days, please contact our medical negligence team on 0800 316 8892.