Hospice Chief Executive Margaret Simpson, Hospice Clinical Director Dr Ben Harris, Noble’s Hospital Medical Director Mr Stephen Upsdell and Chief Nurse Bev Critchlow have issued the short statement below, following the UK review of the Liverpool Care Pathway. This UK review dated 15th July 2013, was led by Baroness Julia Neuberger and has recommended that this end of life care tool is phased out over the next 6 months to one year.
In the Isle of Man, Hospice and the Department of Health, primarily Noble’s Hospital and Ramsey and District Cottage Hospital, work in close partnership and together have been instrumental in implementing the Liverpool Care Pathway (LCP), providing training, putting strict and clear safety measures in place to ensure that is used correctly and evaluating its effectiveness.
The Liverpool Care Pathway (LCP) is a framework and a set of documents that aim to promote best practice when caring for people at the end of their life. It is based on a model of care that the hospice movement developed more than 50 years ago and thus changed the experience of patients and families helping them to feel better, be pain free and finally die in peace, with dignity surrounded by their loved ones. The idea to use the LCP in all healthcare settings, including Hospital, was to help staff working in those areas to give people who are dying the same sort of high quality care that patients get in a hospice.
The “More Care, Less Pathway: A review of the Liverpool Care Pathway” commissioned by the UK Care and Support Minister Norman Lamb found that in the right hands, the LCP supports people to experience high quality, compassionate care in the last hours and days of their life but if implemented by those who do not understand it or are not trained in its use, it can be incorrectly used.
Hospice Isle of Man and the Department of Health have welcomed the review of the LCP, especially its recommendations for improved access to specialist palliative care and development of individual care plans.
There is no evidence that it has ever been used inappropriately on the Isle of Man. However we do acknowledge that in some hospitals in the UK some staff misunderstood and misused the tool. Training has been inadequate and stories of failings to look after the dying patients with care and compassion have been reported.
In view of these findings and the subsequent UK Government’s LCP review, Hospice Isle of Man and the Department of Health will continue to provide high quality, person centred, individualised, dignified care for the dying patients however, we will suspend the use of the LCP documentation and will continue to support all our colleagues in healthcare and teach the principles and practice of palliative care to all who care for the dying. We will work closely with doctors and nurses to ensure that dying patients will have a personalised end of life care plan as we strongly believe that everyone should have access to the best possible care at the end of life, whoever they are, whatever their illness and wherever they end their lives.