The Liverpool Care Pathway

The National Council for Palliative Care has commented as follows in response to recent media coverage of the Liverpool Care Pathway:

The Liverpool Care Pathway is a nationally-recognised evidence-based tool intended to help clinicians give appropriate and high-quality care to people who have reached the last few hours or days of life. Its purpose is to promote the comfort of dying people and to address the needs of their informal carers. It should not be substituted for a clinician’s professional judgement in the individual circumstances of each case.

The LCP is only used when a team of doctors and nurses have agreed that a person is dying and that all reversible causes have been considered. It enables frequent assessment of care and includes discussion with relatives and carers. It is only one of a range of tools available to support good end of life care, and does not encourage “tick box medicine” which can never be justified. Like all tools, it should be used by people who are skilled and competent.

Professor Mayur Lakhani CBE, NCPC’s Chair, said:

	The Liverpool Care Pathway is good and safe to use. As a practising GP, I have seen how it has transformed quality of care for dying patients and their families.

Improving end of life care is increasingly regarded as a major national priority. However at present, too many professionals have to care for people at the end of life without having had appropriate training. That must change, urgently. Core training in palliative care must become compulsory for all health and social care professionals, both before they qualify and as part of their continuing education. Without this we will not bring about the improvements we all want to see.

People at the end of life and their relatives should be given accurate information about the care that is available to them, including the Liverpool Care Pathway. These issues should not be debated or reported in an inflammatory way. Otherwise there are risks both of causing unnecessary distress at a most vulnerable time in people’s lives and of preventing people from receiving the care that they need.

Like any tool, the LCP can be misused. If and where there is evidence that the LCP is being applied inappropriately that should be examined, and consideration should be given to the training and competence of those responsible.

Further Links

Improving end of life care is becoming an increasingly important priority for the nation. However people and professionals often find it difficult to discuss issues involving death, dying and bereavement and this can inhibit good care. NCPC has therefore set up the national Dying Matters coalition with the long-term aim of enabling people to engage with and make plans about death and dying in a more confident and well-informed way.

More information about the coalition can be found here.

The Association for Palliative Medicine of Great Britain and Ireland has issued a statement about the LCP which can be accessed here.