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    Liverpool Care Pathway: A Flawed Death Plan Or A Scapegoat?
    By News Staff | December 17th 2013 07:30 AM | Print | E-mail | Track Comments

    After a series of media stories about the Liverpool Care Pathway being systematic malnutrition, dehydration and premature death in patients across a wide age-range, it was subjected to review by a panel which delivered their findings on 15 July 2013 saying that
    the Liverpool Care Pathway
    needed to abandon its name, as well as the use of the word "pathway", and that the
    the Liverpool Care Pathway
    should be replaced within 12 months by an "end of life care plan". 

    Claud Regnard, FRCP, a palliative care consultant writing in Age and Ageing, calls the demise of the Liverpool Care Pathway a "tragedy" and compared it to banning the Highway Code because of bad drivers. Regnard rejects some of the Neuberger report findings and says instead that there were  many other reasons for poor care and that the
    Liverpool Care Pathway
    has been made "a scapegoat".  

    Regnard also calls some of the report's recommendations "puzzling", stating that "their suggestion to replace the LCP with an "end of life care plan" creates a plan with death as an end point, the same criticism they leveled at the LCP. They also expect the Care Quality Commission to carry out a thematic review within 12 months of how dying patients are treated, which Regnard describes as "rather like setting a handwriting test but confiscating the only pen beforehand."

    "The most puzzling omissions were not to consider the distress of partners and relatives at the mention of a document that had been discredited by a national review and to make no provision for a replacement tool."

    Regnard does concede that the
    Liverpool Care Pathway had flaws, suggesting that audits could have focused more on delivery than documentation and that training should have been made mandatory, but argues that the LCP itself was not the cause of poor care. Discrediting it, he warns, "will ensure that those who remain ignorant or negligent will continue their poor practice without fear of being discovered for the years it may take to produce an alternative."

    However, the Neuberger report does contain components that he believes will be of benefit to patients, particularly the plea for personalized care and the proposal to set up a national alliance looking at end of life care. 

    Regnard says, "the death of the Liverpool Care Pathway was preventable, an irony that was lost in the rush to pronounce its demise and promote the message of a listening government."