Liverpool Pathway replacement ???

[chenrezig]

New end-of-life care rules are 'worse than the death pathway': New rules could leave staff to 'guess' which patients are dying

An expert claims new end-of-life care guidelines are 'dangerous and wrong'
Professor Patrick Pullicino is a leading critic of the Liverpool Care Pathway
But he says the new NHS rules could be even more disastrous than LCP
Much-criticised LCP phased out in 2014 after fears patients being starved

http://www.dailymail.co.uk/news/article ... thway.html

End-of-life care guidelines are ‘dangerous and wrong’ and could be even more disastrous than the controversial Liverpool Care Pathway they replaced, an expert claims.

Patients could find themselves in an early grave thanks to the new NHS rules, which could leave staff to ‘guess’ which are dying and hasten their death, he said.

Professor Patrick Pullicino, a leading critic of the Liverpool Care Pathway, said the latest proposals from the National Institute of Health and Care Excellence were ‘totally wrong and very misleading’ on the crucial subject of patient hydration.

Not an improvement: An expert has claimed that new end-of-life care guidelines are ‘dangerous and wrong’ and could be even more disastrous than the controversial Liverpool Care Pathway they replaced. He said: ‘Overall they’re quite similar to the Liverpool Care Pathway, they still have the problem of diagnosis but in addition, in terms of hydration, the language is very ambiguous. 'There is even a part there that says that withholding artificial nutrition does not hasten death. It’s definitely going to. The whole area on hydration was so badly written – it is so misleading and it is wrong.’
Developed in the 1990s at a Liverpool hospital, the much-criticised LCP was phased out in 2014 after fears grew that patients were being starved and left to suck on sponges for a drop of water.

Written as a treatment programme for looking after the dying, it was axed after examples of neglect and inappropriate treatment came to light.

But Professor Pullicino claims the new proposals mimic many of the LCP’s key problems, including how hospital staff decide who is actually dying. Professor Patrick Pullicino said the latest proposals from the National Institute of Health and Care Excellence were ‘totally wrong and very misleading’ on the crucial subject of patient hydration. He added: ‘The problem all along with the LCP was how staff were left to guess who was dying without any proper diagnosis, but this just skips over that and doesn’t go into it. 'By this time we should be either concentrating and knowing better and doing some research on it, or else we should just take these pathways away.’

In one section of NICE’s 32-page report, proposals advise hospital staff to look out for ‘signs’ and ‘changes’, like fatigue and agitation, to suggest someone is entering their final days.

A professor of clinical neuroscience at the University of Kent, Professor Pullicino had a patient survive 14 months after being taken off the LCP. He recommends a return to ‘ordinary compassionate care’. He said: ‘I think that ordinary compassionate care is better than poor pathway care, and the pathways have nothing to add really over good compassionate care. It’s wrong to keep on trying to reintroduce them in various forms. ‘I think you’ll have the same thing as we had with the Liverpool Pathway, and if anything, it’ll be worse because there won’t be any way to stop it.
‘They’ll say “we’ve actually put in new guidelines, these are an improvement” and it’ll be very difficult to prove people wrong at that point until the figures start showing that mortality has gone up again.’

A NICE spokesman said: ‘The draft guideline is open for public consultation and we welcome any comments.’

[wendy]

I hope members will do the short survey request about this which I posted yesterday.