Is the criticism of Pathway unfair? (From Daily Echo)

Is criticism of Liverpool Care Pathway unfair?

1:20pm Tuesday 8th January 2013 in Health Photograph of the Author By Bethan Phillips, Reporter

Care for the dying.

IT IS the issue that has caused a storm of controversy among Daily Echo readers.

Families concerned about the care of elderly relatives, NHS workers and antieuthanasia campaigners have all got in touch with their views on a controversial scheme to treat dying patients.

The Daily Echo investigation on Saturday aimed to discover the facts about the Liverpool Care Pathway (LCP), which health bosses say ensures terminally ill patients get the right care.

It was in response to national headlines that called the system a “scandal” – and claimed that patients were being put on the pathway without the consent of their relatives.

Disturbing stories about the LCP – including those of loved-ones being denied food and drink in their dying days – have led some families to reject it.

But experts in Southampton have said that the pathway has been unfairly “demonised”.

We questioned healthcare authorities to unearth the facts behind LCP, who told us:

The pathway is only used when a team caring for the patient agrees that the patient is dying.
Patients are not starved to death – those on the LCP are “actively dying” and at that stage nutrition and hydration is not needed. Foods and fluids are not routinely withheld.
According to health bosses in Southampton, whenever possible patients, families, carers and staff are all involved in an open discussion before starting the LCP.
The pathway does not cause a patient to die and there are cases when people get better and are taken off the LCP.

The University Hospital Southampton (UHS), which runs Southampton General Hospital and Princess Anne Hospital and the Countess Mountbatten House, was one of the first waves of trusts to implement the LCP five years ago.

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They say it is about making dying as peaceful as it can be for both patients and their relatives, and it is an approach that has been backed by leading health organisations and charities – including Marie Curie, the Royal College of Nursing and Macmillan.

Southampton General Hospital previously had around 50 per cent of all its adult dying patients on the LCP – but the recent negative media coverage has caused that to drop.

And since the Daily Echo covered the issue on Saturday, we have been inundated with online comments and letters about LCP.

Here we take another look at the debate, and reveal some of your views and experiences.

Gerald Drabble with his sons Aaron, left, and Owen who are campaigning to increase government funding into cancer research and care after Gerald’s wife Becki

‘They did a fantastic job, but there was no consultation’

SHE will never be forgotten.

But along with memories of the life of Hampshire mum Becki Drabble, her loved-ones have also
been left with a long list of unanswered questions about her care.

Becki, 45, had battled cervical cancer since 2008, undergoing numerous treatments and operations.

In September 2012, she was taken to Queen Alexandra Hospital in Cosham with pains in her legs – initially thought to have been caused by a trapped nerve.

But further investigations revealed that tumours were growing from her pelvis, cutting off blood supply.

It was a devastating diagnosis – but her husband Gerald, 41, from Fareham, says he was not properly consulted about his wife’s care.

The couple only realised by accident that Becki had been put on the controversial Liverpool Care
Pathway (LCP) – even though they had spoken to a consultant about Becki’s prognosis.

According to Mr Drabble, fluids were withdrawn and within hours Becki, who has two young sons, had died.

Mr Drabble explains: “I was greatly upset that nobody told me.

“I said to a nurse: ‘Any chance Becki could have a cup of tea?’ and she said she wasn’t sure because Becki was on the LCP.

“That was the first we knew about it.

“When I had earlier been called in to talk to the consultant, it was just a case of him saying: ‘We think we’re in the final stages of life.’

“With the greatest respect, they did a fantastic job and I can’t find fault with the care she got.

“But the consultation and being briefed on what was happening just disappeared – there was none at all.

“I want to know why it was deemed necessary to put her on the LCP. I’m thinking now, could she have been saved? Would it have let her linger if she hadn’t gone on LCP? Could we be bringing her home?

“But as hard as it is, I try not to dwell on that question because someone could give me an answer I don’t want to hear.

“Life goes on and we have had to get on with it.”

Mr Drabble has written to QA, asking for his questions to be addressed.

Portsmouth Hospitals NHS Trust, which runs the hospital, told the Daily Echo that they were
investigating Mr Drabble’s query.

A trust spokesperson said: “Patient care and experience is, and will always remain, the highestpriority for the trust and feedback is much valued.

“The trust has open correspondence with this gentleman and we are unable to provide comments on this individual case."

Comments(16)

cantthinkofone says...
5:08pm Tue 8 Jan 13

Article currently ends with "Here we take another look at the debate, and reveal some of your views and experiences."

Erm... Go on then!

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Frank28 says...
8:26pm Tue 8 Jan 13

How would you feel being put on the LCP?

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arthur dalyrimple says...
10:06pm Tue 8 Jan 13

Its Hitlers T4 code under another name , mass murder is always wrong ,
Hippocratic oath,my elbow.

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sparkster says...
11:51pm Tue 8 Jan 13

Disgusting why wasnt Mr Drabble consulted about his wife being on the care pathway, shameful, as arthur dalrymple rightly says hippocratic oath my elbow

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lynn powell says...
11:54pm Tue 8 Jan 13

on the 6th of december 2012 my father finally lost his battle with lung cancer he weighed about 5 stone 2 weeks previous to this one of his comments was if i was a dog u would not allow me to suffer like this. my mother nursed my father for a year and 1 week from being diagnosed with lung cancer on the 29.11.2011 on the 2.12.2012 my fathers condition detoriated severely we were made aware of the lcp it was explained fully to us what it means and if my father rallied he would be taken off of it my father was put onto the lcp with the full consent of his family at the time of my father going onto this he could not eat or swallow any fluids because the tumour was now from his lung into his throat for 5 days and 4 nights we sat with him praying for him to go to sleep so that he was not suffering anymore and to be at peace for those of u who think u understand if u have never sat with anyone that is dying from this awful disease then u have no right to comment i wish that euthanasia was in place so that my father could of passed away on the sunday and not suffered any longer we were fully explained as to what the lcp meant and under no circumstances was my father deprived of food or fluids the care from all of the district nurses and our gp was absolutely amazing so before all the higher and hollier than thou pass judgement on the lcp sit with a family that is losing a loved one to cancer and maybe just maybe you will understand the lcp it is not back door euthanasia it allows the person dieing to die dignified and with their family with them .Instead of slandering and criticising try putting some more money where it is needed the pallitive case nurses were understaffed so my sister and i had to help the d/nurse wash and change my father for the last four days of his life so i suggest instead of slandering the lcp investigate properly before you have the right to judge. .

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Raxx says...
8:24am Wed 9 Jan 13

lynn powell wrote:
on the 6th of december 2012 my father finally lost his battle with lung cancer he weighed about 5 stone 2 weeks previous to this one of his comments was if i was a dog u would not allow me to suffer like this. my mother nursed my father for a year and 1 week from being diagnosed with lung cancer on the 29.11.2011 on the 2.12.2012 my fathers condition detoriated severely we were made aware of the lcp it was explained fully to us what it means and if my father rallied he would be taken off of it my father was put onto the lcp with the full consent of his family at the time of my father going onto this he could not eat or swallow any fluids because the tumour was now from his lung into his throat for 5 days and 4 nights we sat with him praying for him to go to sleep so that he was not suffering anymore and to be at peace for those of u who think u understand if u have never sat with anyone that is dying from this awful disease then u have no right to comment i wish that euthanasia was in place so that my father could of passed away on the sunday and not suffered any longer we were fully explained as to what the lcp meant and under no circumstances was my father deprived of food or fluids the care from all of the district nurses and our gp was absolutely amazing so before all the higher and hollier than thou pass judgement on the lcp sit with a family that is losing a loved one to cancer and maybe just maybe you will understand the lcp it is not back door euthanasia it allows the person dieing to die dignified and with their family with them .Instead of slandering and criticising try putting some more money where it is needed the pallitive case nurses were understaffed so my sister and i had to help the d/nurse wash and change my father for the last four days of his life so i suggest instead of slandering the lcp investigate properly before you have the right to judge. .

Thank you for posting this. It's important that people like you speak up against the rabid mob and their hysterical, ignorant, irresponsible accusations and conspiracy theories.

[quote][p][bold]lynn powell[/bold] wrote: on the 6th of december 2012 my father finally lost his battle with lung cancer he weighed about 5 stone 2 weeks previous to this one of his comments was if i was a dog u would not allow me to suffer like this. my mother nursed my father for a year and 1 week from being diagnosed with lung cancer on the 29.11.2011 on the 2.12.2012 my fathers condition detoriated severely we were made aware of the lcp it was explained fully to us what it means and if my father rallied he would be taken off of it my father was put onto the lcp with the full consent of his family at the time of my father going onto this he could not eat or swallow any fluids because the tumour was now from his lung into his throat for 5 days and 4 nights we sat with him praying for him to go to sleep so that he was not suffering anymore and to be at peace for those of u who think u understand if u have never sat with anyone that is dying from this awful disease then u have no right to comment i wish that euthanasia was in place so that my father could of passed away on the sunday and not suffered any longer we were fully explained as to what the lcp meant and under no circumstances was my father deprived of food or fluids the care from all of the district nurses and our gp was absolutely amazing so before all the higher and hollier than thou pass judgement on the lcp sit with a family that is losing a loved one to cancer and maybe just maybe you will understand the lcp it is not back door euthanasia it allows the person dieing to die dignified and with their family with them .Instead of slandering and criticising try putting some more money where it is needed the pallitive case nurses were understaffed so my sister and i had to help the d/nurse wash and change my father for the last four days of his life so i suggest instead of slandering the lcp investigate properly before you have the right to judge. .[/p][/quote]Thank you for posting this. It's important that people like you speak up against the rabid mob and their hysterical, ignorant, irresponsible accusations and conspiracy theories. Raxx

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peter sowerby says...
10:31am Wed 9 Jan 13

I am sorry for your sad loss of you father. His death as you have sadly described was not a LCP controlled termination, as I lost my father in the same way but in Countess Moutbatten ward.
If you read the reason and cause for death on the post -mortem form and the death certificate it will clearly state his death was caused by only cancer or other related diseases.Your comments have already be seized on by LCP euthanasia supporters. Please consider thousands of patients in hospitals,care and nursing home are facing death without even knowing they have been placed on the death care path and not even given the chance like us to say the final goodbye to their love one's. Please join me and help expose this human injustice.LCP is illegal and must be tested in a court of law.

Report this post »

peter sowerby says...
10:49am Wed 9 Jan 13

cantthinkofone wrote:
Article currently ends with "Here we take another look at the debate, and reveal some of your views and experiences." Erm... Go on then!

He is another bit of bad news for LCP supporters.Todays news that the Government Care Quality Commission who's job is to check whether hospitals,care homes and care services are meeting national standards have been blown out of the water as a complete failure an not fit for purpose.They fully support LCP that says it all.

Report this post »

peter sowerby says...
10:55am Wed 9 Jan 13

Raxx wrote:

lynn powell wrote: on the 6th of december 2012 my father finally lost his battle with lung cancer he weighed about 5 stone 2 weeks previous to this one of his comments was if i was a dog u would not allow me to suffer like this. my mother nursed my father for a year and 1 week from being diagnosed with lung cancer on the 29.11.2011 on the 2.12.2012 my fathers condition detoriated severely we were made aware of the lcp it was explained fully to us what it means and if my father rallied he would be taken off of it my father was put onto the lcp with the full consent of his family at the time of my father going onto this he could not eat or swallow any fluids because the tumour was now from his lung into his throat for 5 days and 4 nights we sat with him praying for him to go to sleep so that he was not suffering anymore and to be at peace for those of u who think u understand if u have never sat with anyone that is dying from this awful disease then u have no right to comment i wish that euthanasia was in place so that my father could of passed away on the sunday and not suffered any longer we were fully explained as to what the lcp meant and under no circumstances was my father deprived of food or fluids the care from all of the district nurses and our gp was absolutely amazing so before all the higher and hollier than thou pass judgement on the lcp sit with a family that is losing a loved one to cancer and maybe just maybe you will understand the lcp it is not back door euthanasia it allows the person dieing to die dignified and with their family with them .Instead of slandering and criticising try putting some more money where it is needed the pallitive case nurses were understaffed so my sister and i had to help the d/nurse wash and change my father for the last four days of his life so i suggest instead of slandering the lcp investigate properly before you have the right to judge. .
Thank you for posting this. It's important that people like you speak up against the rabid mob and their hysterical, ignorant, irresponsible accusations and conspiracy theories.

Come on lets test LCP in a court of law. Its euthanasia its illeagal and you know it ie cause of death certificate should read murder.

[quote][p][bold]Raxx[/bold] wrote: [quote][p][bold]lynn powell[/bold] wrote: on the 6th of december 2012 my father finally lost his battle with lung cancer he weighed about 5 stone 2 weeks previous to this one of his comments was if i was a dog u would not allow me to suffer like this. my mother nursed my father for a year and 1 week from being diagnosed with lung cancer on the 29.11.2011 on the 2.12.2012 my fathers condition detoriated severely we were made aware of the lcp it was explained fully to us what it means and if my father rallied he would be taken off of it my father was put onto the lcp with the full consent of his family at the time of my father going onto this he could not eat or swallow any fluids because the tumour was now from his lung into his throat for 5 days and 4 nights we sat with him praying for him to go to sleep so that he was not suffering anymore and to be at peace for those of u who think u understand if u have never sat with anyone that is dying from this awful disease then u have no right to comment i wish that euthanasia was in place so that my father could of passed away on the sunday and not suffered any longer we were fully explained as to what the lcp meant and under no circumstances was my father deprived of food or fluids the care from all of the district nurses and our gp was absolutely amazing so before all the higher and hollier than thou pass judgement on the lcp sit with a family that is losing a loved one to cancer and maybe just maybe you will understand the lcp it is not back door euthanasia it allows the person dieing to die dignified and with their family with them .Instead of slandering and criticising try putting some more money where it is needed the pallitive case nurses were understaffed so my sister and i had to help the d/nurse wash and change my father for the last four days of his life so i suggest instead of slandering the lcp investigate properly before you have the right to judge. .[/p][/quote]Thank you for posting this. It's important that people like you speak up against the rabid mob and their hysterical, ignorant, irresponsible accusations and conspiracy theories.[/p][/quote]Come on lets test LCP in a court of law. Its euthanasia its illeagal and you know it ie cause of death certificate should read murder. peter sowerby

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lynn powell says...
11:57am Wed 9 Jan 13

lcp didnot kill my father he had lung cancer copd asbestosis and emthazeamia he was allowed to die at home with his family his death certificate stated these causes lcp if explained correctly informs the family that your loved one is in the final stages of life at no point was anything untoward done to my father he had been on a syringe driver for 8 weeks . he eventually passed away peacefully at home where he wanted to be with his family what right do the people who do not understand lcp or who have never ever had to sit with anyone that is suffering from cancer to comment lets hope all these ignorant people will not one day be in this situation . as i said before investigate and get the correct facts before criticising.

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lynn powell says...
8:33pm Wed 9 Jan 13

how rude i am not a hysterical dribbling fool.
used under the correct circumstances and in the appropriate place lcp is appropriate when explained correctly and yes maybe it should be a court of law that decides if it is illegal or not i am not ignorant either i work for the nhs and just to inform you i do believe in euthanasia
again when appropriate

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lynn powell says...
9:37pm Wed 9 Jan 13

lynn powell wrote:
how rude i am not a hysterical dribbling fool.
used under the correct circumstances and in the appropriate place lcp is appropriate when explained correctly and yes maybe it should be a court of law that decides if it is illegal or not i am not ignorant either i work for the nhs and just to inform you i do believe in euthanasia
again when appropriate

raxx please accept my apologies for my previous comment i assumed it was for me and i do believe everyone is entitled to their opinion without the care of the nursing and drs team that looked after my father and him being on the lcp we would not of been able to care for him at home and to keep him at home ans spend that precious time with him but as i said lcp is appropriate as i said when used correctly and explained correctly

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Pikey-Biker says...
11:56pm Wed 9 Jan 13

peter sowerby wrote:
I am sorry for your sad loss of you father. His death as you have sadly described was not a LCP controlled termination, as I lost my father in the same way but in Countess Moutbatten ward. If you read the reason and cause for death on the post -mortem form and the death certificate it will clearly state his death was caused by only cancer or other related diseases.Your comments have already be seized on by LCP euthanasia supporters. Please consider thousands of patients in hospitals,care and nursing home are facing death without even knowing they have been placed on the death care path and not even given the chance like us to say the final goodbye to their love one's. Please join me and help expose this human injustice.LCP is illegal and must be tested in a court of law.

it isn't illegal is it Peter.

Anyways Peter I have some of your posts to reply to on the other forum on this topic

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Pikey-Biker says...
3:15am Thu 10 Jan 13

come on Peter in the other forum you stated that " . Starving and dehydrating a patient to death for 30 days plus is not euthanasia its murder that needs to be tested in a court of law."

still waiting for your answer

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Raxx says...
8:47am Thu 10 Jan 13

lynn powell wrote:

lynn powell wrote:
how rude i am not a hysterical dribbling fool.
used under the correct circumstances and in the appropriate place lcp is appropriate when explained correctly and yes maybe it should be a court of law that decides if it is illegal or not i am not ignorant either i work for the nhs and just to inform you i do believe in euthanasia
again when appropriate
raxx please accept my apologies for my previous comment i assumed it was for me and i do believe everyone is entitled to their opinion without the care of the nursing and drs team that looked after my father and him being on the lcp we would not of been able to care for him at home and to keep him at home ans spend that precious time with him but as i said lcp is appropriate as i said when used correctly and explained correctly

Lol. Not a problem Lynn, it was pretty clear you'd firmly grasped the wrong end of the stick! :-D

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Pikey-Biker says...
11:44pm Thu 10 Jan 13

peter sowerby wrote:

cantthinkofone wrote: Article currently ends with "Here we take another look at the debate, and reveal some of your views and experiences." Erm... Go on then!
He is another bit of bad news for LCP supporters.Todays news that the Government Care Quality Commission who's job is to check whether hospitals,care homes and care services are meeting national standards have been blown out of the water as a complete failure an not fit for purpose.They fully support LCP that says it all.

Peter,
The fact the CQC being branded not fit for purpose has been known for well over a year, and to be honest it’s hardly surprising. When it was set up in 2009 it replaced 3 ‘commissions’ Healthcare Commission and the Commission for Social Care Inspection. The Mental Health Act Commission it began with a smaller budget than the combined funding of its three predecessors and, according to both supporters and critics, too broad a remit.
On your last point they don’t fully support the LCP, I found this link http://www.cqc.org.u
k/public/news/report
ing-concerns-about-l
iverpool-care-pathwa
y

Hey why don’t you tell them about the patient that starved for 30 days?

Somehow I don’t think you will

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Is the criticism of Pathway unfair? (From Daily Echo)

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