THE architects of the Liverpool Care Pathway (LCP) today broke their silence about the controversial model of care that has faced an onslaught of criticism in recent weeks.
One national newspaper has even branded the end of life plan now adopted throughout the UK as being a “pathway to death”.
Worryingly, critics of the LCP said that hospitals are even being given financial rewards worth millions of pounds to put patients on the regime.
Senior cancer doctor Prof Mark Glaser accused NHS managers of using the pathway to clear beds and achieve targets.
But today the people behind the care plan hit back.
Prof John Ellershaw, director of the Marie Curie palliative care institute Liverpool and Deborah Murphy, associate director, said: “The sole purpose of the LCP is to provide the best possible care for people in the last days or hours of their life.
“That was the purpose when we at the Marie Curie and our partners in Liverpool set out in the 1990s to design a framework for health professionals to use to ensure that people who are dying have as comfortable and dignified a death as possible, and it remains the purpose today.
“It was a response to the poor care and suffering of dying patients in hospitals in this country, and we had a simple aim: to bring best care of the dying – of the type that people experienced in hospices – to the wards of general hospitals.
“Since the 1990s, the LCP has been developed, supported by evidence and research of the highest quality. Remaining central to the LCP, however, are good care, compassion and communication.”
It has been reported the LCP involves the withdrawal of life-saving treatment with patients sedated and the majority denied nutrition and fluids by tube. But The Post was told that the LCP is not a ‘one size fits all’ prescription but tailored to each patient.
And medics say the LCP – a document that helps them manage end of life care – does not recommend continuous deep sedation but a review of medications and open discussions with relatives. If possible, patients may stop unnecessary treatments and interventions, shifting the focus of care to comfort and dignity.
Supporters strongly refute the LCP is a form of “euthanasia”.
Families fear loved ones are being put on the pathway to hasten death.
But Prof Ellershaw and Ms Murphy said: “Many, many thousands of patients and their families have benefited from improved care as a result of the LCP.
“The provision or withdrawal of interventions with the direct aim of hastening death is contrary to the rationale of the LCP, contrary to GMC (General Medical Council) guidance, and illegal.”
While Prof Ellershaw and Ms Murphy are the main architects of the LCP, responsibility for day-to-day implementation lies with individual hospitals, GPs and care homes.
Experts argue that before the LCP, there was not such a formal approach to end of life care which led to poor care in the final days of life in some instances, including unnecessary medical treatments.
While written consent is not needed before a patient is put on the plan, Prof Ellershaw and Ms Murphy added that “there should never be an occasion when the relative or carer who is named as the first contact or next of kin is unaware of the diagnosis of dying or of the subsequent care plan”.
Peter Williams, medical director at Royal Liverpool Hospital – part of the collaborative along with Liverpoool University – added: “Hospitals receive payments for ensuring patients are provided with high quality care across a range of measures. These may include preventing patients from dying from pneumonia, stroke and heart disease.
“They may include ensuring patients are kept safe from MRSA or that in the last moments of their life, patients are supported with the type of best practice, evidence-based care outlined in the LCP.
“The key word is ‘Care’. When it comes to my own death, I would like to be supported by the LCP.”