The Liverpool Care Pathway is dead, but we must still address how we care for the dying

It is now clear that the "one or two mistakes" were in fact overwhelming problems, but phasing out the LCP still leaves the problems it was created to resolve

Share
Related Topics

Just six months ago, health secretary Jeremy Hunt described the controversial Liverpool Care Pathway as a "fantastic step forward" and urged that "one or two mistakes" should not be allowed to discredit the end-of-life system.

In an interview with LBC radio in January he said: ‘I would be very sad if as a result of something that is a big step forward going wrong in one or two cases we discredited the concept that we need to do a lot better to give people dignity in their final hours because it’s something we haven’t done well. Lots of people don’t want to die with lots of tubes going in and out of their body – they actually want to die in a dignified way.’

Today, Care Services Minister Norman Lamb will confirm that the LCP is to be phased out within a year following a review he commissioned from Baroness Julia Neuberger which found that the "one or two mistakes" were in fact overwhelming problems. Yet phasing out the LCP does not address the fundamental problem that Mr Hunt alluded to - we need to do a lot better to give people dignity in their final hours.

The problems identified by the Neuberger review were not with the principle of the LCP - providing that dignity - but with its practice. Hospitals exist to heal patients - to make them better so that they can return to their families. Hospitals  are much less good at caring for dying patients - those who are not going to recover and need to be kept comfortable and pain free in their final hours. The last thing such patients need is aggressive treatment with toxic drugs, violent attempts at resuscitation or invasive surgery - yet many still receive it.

Death is a process, not an event and when this irreversible point has been reached  the role of medicine must be to assist nature, not fight against it. Patients refuse food and drink as part of this natural process as the body shuts down. The LCP has been accused of leading to the deliberate "starvation" of patients when its intention is to avoid the force feeding of them.

It is in its practice that the LCP has failed. Far too many patients in far too many hospitals were placed on the pathway without their knowledge or consent or, most importantly, that of their families who were then faced with witnessing their loved ones decline without understanding what was going on.

To add insult to injury, hospitals received financial incentives to place people on the pathway. Again the intention was good - to ensure as many dying patients as possible had a dignified death. But it led to allegations that they were being "bribed" to put patients to death and the Neuberger review rightly says this must be ended.

Good communication, and good training for staff, is vital in this delicate are of medicine. The Neuberger review recommends "individual end of life care plans." But this does not address the central difficulty with the LCP - our reluctance to discuss issues surrounding death. The LCP itself may now be dead - but a better way of caring for the dying, sensitively implemented, is still desperately needed.

React Now

Latest stories from i100
Have you tried new the Independent Digital Edition apps?
iJobs Job Widget
iJobs General

Marketing Manager - Leicestershire - £35,000

£30000 - £35000 per annum: Ashdown Group: Marketing Manager (CIM, B2B, MS Offi...

Marketing Executive (B2B and B2C) - Rugby, Warwickshire

£22000 - £25000 per annum: Ashdown Group: A highly successful organisation wit...

SEN Coordinator + Teacher (SENCO)

£1 per day: Randstad Education Leeds: Job Purpose To work closely with the he...

Research Manager - Quantitative/Qualitative

£32000 - £42000 Per Annum: Clearwater People Solutions Ltd: Our client is curr...

Day In a Page

Read Next
Holly's review of Peterborough's Pizza Express quickly went viral on social media  

The response to my Pizza Express review has been overwhelming, and taught me a lot about journalism

Holly Aston
3 Donatella Versace and Audrey  

Errors and Omissions: We were having a blond moment – maybe two

John Rentoul
Mystery of the Ground Zero wedding photo

A shot in the dark

Mystery of the wedding photo from Ground Zero
His life, the universe and everything

His life, the universe and everything

New biography sheds light on comic genius of Douglas Adams
Save us from small screen superheroes

Save us from small screen superheroes

Shows like Agents of S.H.I.E.L.D are little more than marketing tools
Reach for the skies

Reach for the skies

From pools to football pitches, rooftop living is looking up
These are the 12 best hotel spas in the UK

12 best hotel spas in the UK

Some hotels go all out on facilities; others stand out for the sheer quality of treatments
These Iranian-controlled Shia militias used to specialise in killing American soldiers. Now they are fighting Isis, backed up by US airstrikes

Widespread fear of Isis is producing strange bedfellows

Iranian-controlled Shia militias that used to kill American soldiers are now fighting Isis, helped by US airstrikes
Topshop goes part Athena poster, part last spring Prada

Topshop goes part Athena poster, part last spring Prada

Shoppers don't come to Topshop for the unique
How to make a Lego masterpiece

How to make a Lego masterpiece

Toy breaks out of the nursery and heads for the gallery
Meet the ‘Endies’ – city dwellers who are too poor to have fun

Meet the ‘Endies’ – city dwellers who are too poor to have fun

Urbanites are cursed with an acronym pointing to Employed but No Disposable Income or Savings
Paisley’s decision to make peace with IRA enemies might remind the Arabs of Sadat

Ian Paisley’s decision to make peace with his IRA enemies

His Save Ulster from Sodomy campaign would surely have been supported by many a Sunni imam
'She was a singer, a superstar, an addict, but to me, her mother, she is simply Amy'

'She was a singer, a superstar, an addict, but to me, her mother, she is simply Amy'

Exclusive extract from Janis Winehouse's poignant new memoir
Is this the role to win Cumberbatch an Oscar?

Is this the role to win Cumberbatch an Oscar?

The Imitation Game, film review
England and Roy Hodgson take a joint step towards redemption in Basel

England and Hodgson take a joint step towards redemption

Welbeck double puts England on the road to Euro 2016
Relatives fight over Vivian Maier’s rare photos

Relatives fight over Vivian Maier’s rare photos

Pictures removed from public view as courts decide ownership
‘Fashion has to be fun. It’s a big business, not a cure for cancer’

‘Fashion has to be fun. It’s a big business, not a cure for cancer’

Donatella Versace at New York Fashion Week