By Matt Gaw
Saturday, January 5, 2013
THOUSANDS of people have died after being put on a controversial “pathway” to death in Suffolk and north Essex, the EADT can reveal.
The Liverpool Care Pathway (LCP) is a system designed to give a hospice standard of care to the terminally-ill and can involve the removal of hydration and nutrition from dying patients.
The use of the framework, which Suffolk doctors said is about making the last hours of life more comfortable rather than “hastening death”, has previously been criticised amid fears that some patients have not told they are on the pathway.
But health bosses and representatives from the British Medical Association (BMA) have insisted that any decision to begin the care pathway in the region’s hospitals is made in partnership with the patient and their carers.
According to figures released under the Freedom of Information (FOI) Act, 389 people died in West Suffolk Hospital after being placed on the LCP between January and November 2012.
In 2011, 432 people died – a significant increase on the 354 people who died in 2010 and the 300 who died in 2009.
A spokeswoman for West Suffolk Hospital, in Bury St Edmunds, said they have a specialist palliative care team to support and educate health care professionals in the use of the LCP and provide training.
She added: “Within this training the importance of good communication is stressed. Patients are informed of their condition and that they are dying when it is possible to do so, but so close to death many patients are confused, sleepy or unconscious and therefore are unable to take part in conversations.
“Some patients do not want to be informed that they are dying and some relatives will give health care professionals good reasons why they do not wish the patient to be informed.”
A spokeswoman for Ipswich Hospital said that between December 1 and November 30, 2012, there were 218 patients with LCP listed in their “discharge summaries”.
She added: “We are committed and are working very hard on whole of our end of life care, which includes as part of that, the LCP. Our team of consultants and nurses are working together with the King’s Fund looking at the bigger project of enhancing and improving care.”
Nicky Goodwin, End of Life Care Facilitator for Colchester Hospital University NHS Foundation Trust, said the numbers of patients put on the LCP had only been recorded from January 2011.
However Mrs Goodwin, who said that 52.6% of adults who died in the first 11 months of 2012 were on the LCP, estimated that about 860 patients on the system would have died in 2011.
She said the LCP is an “important part” of making loved ones’ final hours as pain-free and dignified as possible.
Mrs Goodwin added: “It is recommended as a model of best practice by the Department of Health and has been adopted in many UK hospitals and other health care settings.”
Meanwhile, a leading Suffolk doctor has defended the use of the LCP in hospitals.
Dr Richard West, MBE, who is a member of the BMA and is a GP in Woolpit, said: “The whole idea is that when you have a patient who is terminally ill and there is nothing else that can sensibly be done to prolong that life, you make those last few days as comfortable as possible rather than letting them languish – for want of better word – on a ward with no one knowing what to do.”
He added: “This is not about starving people to death it is about making sure they don’t suffer more through the process of dying.
“A natural part of dying is that you don’t eat or drink as much. You fade gradually away.”