Scrapping Liverpool Care Pathway 'must not leave patients in limbo'

The Liverpool Care Pathway is to be scrapped within the next six to 12 months, the DH has revealed.

End of life care: overhaul planned
End of life care: overhaul planned

GP leaders warned that plans to scrap the scheme must not leave patients in limbo while an alternative is set up, and that it would be wrong to completely abandon a system that is in principle a 'useful, evidence-based framework'.

A review of the programme led by Baroness Neuberger, which published its findings on Monday, revealed that 'in the right hands and when operated by well-trained, well-resourced and sensitive clinical teams the Liverpool Care Pathway (LCP) does help patients have a dignified and pain-free death'.

But it also found 'too many cases' of poor quality care.

Health minister Norman Lamb, who commissioned the review, has ordered hospitals to review all care of patients who are dying and to place 'named senior clinicians' in charge of each patient's care.

The LCP will be 'phased out over the next six to 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's chief inspectors - including for primary care - will also be called in to review end of life care and factor it in to plans for inspections.

Mr Lamb said: 'We hope the actions we have taken today will reassure patients and their families that everyone coming to the end of their life is getting the best possible care and that concerns are being dealt with swiftly.'

RCGP chairwoman Professor Clare Gerada said: 'The college has always supported the principles behind the LCP as a useful, evidence-based framework to support the delivery of excellent care to patients in the last days and hours of their lives. However, we have expressed concern about the implementation of the LCP and so welcome many of Baroness Neuberger's recommendations to address this.

She said a move towards more personalised care was a 'positive step'. But she added: 'It is important not to throw the baby out with the bathwater. We need to take what has been shown to work from the existing LCP and make sure that it is implemented consistently across the country to ensure that all patients receive high quality and compassionate end of life care.'

Former RCGP chairman Professor Mayur Lakhani, chair of the National Council for Palliative Care, said: 'Five years on from the End of Life Care Strategy, NHS England now has an important opportunity to set out plans for priority actions in end of life care, including arrangements to make sure that no one is left in limbo during the transition from the Liverpool Care Pathway to personalised end of life care plans.'

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