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End of life care pathway unveiled

A new approach to looking after dying people has been released to succeed the Liverpool Care Pathway (LCP).

Following claims the that LCP was implemented without consent leaving elderly people without food and drink, the system of caring for people at the end of life was scrapped.

The priorities introduced by Care and Support Minister Norman Lamb today aim to create a “personalised and proactive” system of palliative care.

The priorities mean that:

 - Decisions about care are made in accordance with the persons needs and wishes. Needs are regularly reviewed and revised.
- Communication between staff and the person who is dying is sensitive.
- The dying person is involved in decisions about treatment and care.
- People important to the dying person are listened to and their needs are respected.
- Care is tailored to the individual and delivered with compassion.

Alliance for the Care of Dying People (LACDP).  The priorities form part of the Alliance's overall response, called 'One Chance to Get it Right', to an independent review of the Liverpool Care Pathway led by Baroness Neuberger.

Jane Cummings, Chief Nursing Officer for England, said: “The priorities for care announced today promote a culture of compassion that puts people and their families at the centre of decisions about their treatment and care. This is something I am passionate about. They also underline the importance of sensitive and effective communication between staff and the person who is dying and those close to them.
 
“As Chief Nursing Officer, I call on individuals who deliver services for people in the last few days and hours of life and their families to make the Priorities for Care part of their practice and to support colleagues in doing the same. I will be writing out to all nurses to inform them and raise awareness of the report of the LACDP.”

The Priorities for Care follow an independent review of the LCP carried out in 2013 by a panel led by Baroness Julia Neuberger.

The review found that where the LCP was used well, it delivered good care, but also found examples of poor care. Issues included a lack of tailored, personalised care and in some cases, the LCP became regarded as a tick box exercise. In many cases relatives and their carers did not feel they were involved in discussions about the care plan. There were also cases of food and liquids unacceptably withheld.

As a result, the review panel recommended that the LCP should be phased out.

Care and Support Minister Norman Lamb, said: “The new priorities will mean that care is focused on dying people's wishes - rather than processes. This will make sure that their voices, and those of their families, are heard at all times.

“The poor care given to some people and their families on the Liverpool Care Pathway must never happen again. There are many shining examples in the NHS of excellent end of life care, and I am committed to making sure that care in the last few days and hours of life is tailored to the needs of each individual.

Support materials for health and care staff are available on the NHS Improving Quality website.