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End of Life Care: A Fresh Approach?

The National Institute for Health and Care Excellence (NICE) has issued new draft guidance aimed at improving the quality of care given to patients who are in the last few days of their lives.

Liverpool Care Pathway

Serious concerns had been raised in relation to the previous system dealing with end of life care, the Liverpool Care Pathway (LCP), by members of the public, healthcare professionals and the media.

Specific complaints included patients being denied food and water and families realising that their relatives had been placed onto the pathway without their knowledge or consent.

It was felt by many that the LCP had become more of an administrative “tick box” exercise and needed to be reviewed so that the pathway for each individual could be tailored to their needs and involve their loved ones as much as possible.

Whilst supporters of the LCP argued that the issues complained about were down to a lack of training and poor implementation of otherwise good guidance, in July 2013 the government announced that the LCP would be replaced.

New draft proposals have now been published by NICE.

New Guidelines

The new draft guidelines emphasise communication and shared decision-making, involving relatives, carers, medical professionals, and patients themselves.

It is recommended that decisions regarding patients who are reaching the end of their lives should be taken by a team of health experts, as opposed to just one doctor, and also recognise that patients who are close to death may recover.

The new guidelines seem to promote a less clinical and more individual approach, although there is no doubt that decisions surrounding end of life care are extremely difficult for all concerned. The new guidelines also lead to the inevitable question of how the NHS will manage to fund such a personalised service.

Have Your Say

Members of the public are able to review and comment on the draft guidelines until 9 September 2015.

Although members of the public cannot directly give feedback to NICE on these proposals, comments can be passed to NHS England, local clinical commissioning groups, (CCG) or the “stakeholder organisation” that most closely represents the person’s interests.

A list of those stakeholder organisations – together with the draft guidelines – can be found on the NICE website.

Ben Reeves is a Trainee Solicitor in the Clinical Negligence department of Slater and Gordon Lawyers in Manchester.

If you have concerns about an elderly person being neglected or mistreated in a nursing or care home, call Slater and Gordon Lawyers for a free consultation on freephone 0800 916 9046. Alternatively contact us online and we will call you.


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