85% of hospital trusts adopt controversial end-of-life care regime

Eighty-five per cent of trusts have adopted a controversial end-of-life care regime which can involve withholding food and drink from terminally-ill patients, figures suggest.

And almost two-thirds of trusts that have used the Liverpool care pathway (LCP) have received financial incentives totalling millions of pounds for the implementation of the method, according to figures from the Daily Telegraph.

Data obtained using the Freedom of Information Act show that 85% of 72 trusts use the method - which recommends that in some circumstances doctors withdraw treatment, food and water from sedated patients in their final days.

Of those trusts, 62% said they had received, or expected to receive, cash incentives for meeting targets associated with the implementation of the LCP, according to the newspaper.

Under a system called Commissioning for Quality and Innovation, NHS commissioners "reward excellence" by paying trusts to meet care targets. The incentives vary from region to region.

The pathway has come under much scrutiny recently.

Reports suggest that doctors are establishing "death lists" of patients to put on the pathway. Articles also claim that hospitals may be employing the method to cut costs and save on bed spaces.

Earlier this week, Tory peer Baroness Knight called for an independent inquiry into the pathway.

But an article in a leading medical journal argued that the pathway has "transformed" end-of-life care.

Using the LCP means that patients can have a "peaceful, pain-free, dignified death", said Glasgow-based general practitioner Dr Des Spence.

Writing in the British Medical Journal (BMJ), Dr Spence said the pathway can offer a "good death" when used properly.

A Department of Health spokesman said: "The Department of Health does not centrally fund any payments for the use of the LCP, but local areas may choose to do so in order to improve the care and support given to people in their last days.

"This means patients can be more comfortable and treated with dignity in their final days and hours.

"The LCP is supported by more than 20 leading organisations, including Marie Curie Cancer Care and Age UK, as a way to help meet the care and dignity needs for those who are at the end of their life.

"We are clear the LCP can only work if each patient is fully consulted, where this is feasible, and their family involved in all aspects of decision-making. Staff must properly communicate with the patient and their family - any failure to do so is unacceptable."

PA