The Government is to replace the Liverpool Care Pathway (LCP) and will ask senior clinicians to sign off all end of life care plans, as part of its response to the findings of an independent review.
The review, headed by Baroness Julia Neuberger, was established by Care and Support Minister, Norman Lamb, after concerns were raised by patients, families, carers and a number of clinicians that the system for providing care in the last days and hours of people’s lives was flawed.
The review found that in the right hands and when operated by well-trained, well-resourced and sensitive clinical teams, the LCP does help patients have a dignified and pain-free death. However, it also found cases of poor practice, poor quality care of the individual, with families and carers not being properly engaged in the patient’s care. Because of these failings in its use, the review has recommended it should be phased out.
The Government has published an initial response to the review, which includes a series of actions for the health and care system, including that:
• All NHS hospitals should immediately undertake clinical reviews of all care given to dying patients. Led by senior clinicians, these reviews will ensure the care all patients are receiving is appropriate.
• All NHS hospitals should ensure that arrangements are put in place as soon as possible so that now and in the future every patient has a named senior clinician responsible for their care in their final hours and days of life.
• NHS England should work with CCGs to bring about an immediate end to local financial incentives for hospitals to promote a certain type of care for dying patients, including the LCP.
• The LCP will be phased out over the next 6-12 months and replaced with an individual approach to end of life care for each patient, which will include a personalised end of life care plan backed up by condition-specific good practice guidance, agreed with a named senior clinician.
• The CQC will undertake a review into end of life care and the three new Chief Inspectors – of Hospitals, Social Care and General Practice – will consider end of life care issues as they develop their new approaches to inspections.
The Government has also promised to give greater assurance to families that their complaints or concerns will be properly listened to.
