Liverpool Care Pathway for the dying patient

The Liverpool Care Pathway for the Dying Patient (LCP) was a UK care pathway (excluding Wales) covering palliative care options for patients in the final days or hours of life. It was developed to help doctors and nurses provide quality end-of-life care. Now discredited, the LCP was widely abused as a 'tick box exercise', with patients being casually assessed as terminal, heavily sedated, and denied water so the diagnosis became self-fulfilling. Hospitals were also provided cash incentives to achieve targets for the number of patients dying on the LCP.

The Liverpool Care Pathway was developed by Royal Liverpool University Hospital and Liverpool's Marie Curie Hospice in the late 1990s for the care of terminally ill cancer patients. The LCP was then extended to include all patients deemed dying.

While initial reception was positive, it was heavily criticised in the media in 2009 and 2012. In July 2013, the Department of Health released a statement which stated the use of the LCP should be "phased out over the next 6-12 months and replaced with an individual approach to end of life care for each patient". However, The Telegraph reported that the program was just rebranded and that its supposed replacement would "perpetuate many of its worst practices, allowing patients to suffer days of dehydration, or to be sedated, leaving them unable to even ask for food or drink."

The Pathway was developed to aid members of a multi-disciplinary team in matters relating to continuing medical treatment, discontinuation of treatment and comfort measures during the last days and hours of a patient's life. The Liverpool Care Pathway is organised into sections ensuring that evaluation and care is continuous and consistent.

It was not intended to replace the skill and expertise of health professionals.

In the first stage of the pathway a multi-professional team caring for the patient is supposed to agree that all reversible causes for the patient's conditions have been considered and that the patient is in fact "dying". The assessment then makes suggestions for what palliative care options to consider and whether non-essential treatments and medications should be discontinued.

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Wikipedia