Questions and answers about the controversial pathway

Q- What is the Liverpool Care Pathway?

A- This pathway is a way of ensuring those who are actively dying are cared for as well as possible and that this care is documented.

Health bosses believe that most people whose death is expected, and who are very near the end of their lives, should be put on either the Liverpool Care Pathway, or a similar pathway, to ensure they are cared for appropriately and that communication with all involved is as good as possible.

It is a recognised model of best medical practice and is supported by 20 national organisations.

The pathway focuses on communication with the patient and family, decision-making and expert symptom management.

Patients on LCP are reviewed regularly by the medical team.

Among many goals of care, patients are individually assessed for their nutrition and hydration status, and a plan made for what is clinically in their best interests, including food and fluid intake.

Q- Why is it called the Liverpool Care Pathway?

A- The specialist palliative care team at the Royal Liverpool and Broadgreen University Hospitals NHS Trust and the Marie Curie Hospice, Liverpool, developed the Liverpool Care Pathway for dying patients in 1997. It is for those in the last days or hours of life.

Basingstoke became one of the first bands of hospitals to introduce the LCP in 2007.

Q- When is a patient started on the LCP?

A- It was introduced to enable health care professionals to focus on care in the last hours or days of life and to stop, think, assess and change care appropriately for the individual person and/or their relative and carers.

Q- When is it used and who decides?

A- It is used when the team caring for the patient agrees that the patient is dying and all reversible causes for the current situation have been considered.

Q- Is the LCP only used for cancer patients?

A- No. The LCP supports care in the last hours or days of life irrespective of diagnosis.

Q- What advantages are there in using the LCP?

A- The Marie Curie Palliative Care Institute in Liverpool believes the LCP supports the healthcare professional and the relatives and carers to achieve the best quality of care at what can be a very difficult time.

Q- How many hospitals implement the LCP?

A- Most hospitals will use the LCP, or a similar end-of-life care pathway. Residential homes, nursing homes and GPs are all able to put a patient on LCP.

Q- Is LCP only used in the UK?

A- No – 18 other countries are registered with the LCP Continuous Quality Improvement Programme.

Q- How many patients in Basingstoke are put on the LCP?

A- Around 275 patients a year at Basingstoke hospital are put on the LCP. The hospital aims to put around 50 per cent of all dying patients in hospital on the LCP.

Q- What is it that the LCP doesn’t do?

A- The LCP does not give hospitals a licence to hasten death. It does not recommend withholding food and water, and putting someone on the LCP is not irreversible. Patients should be reviewed every four hours and fully reassessed every three days or in response to a number of triggers.

Q- Does the LCP help to deal with other aspects of care, such as how the family is coping?

A- Yes, the LCP includes specific goals of care related to communication, spiritual and religious care of the patient and the family and the changes that are expected in the last hours or days or life.

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