Views & Reviews Personal View

We need an alternative to the Liverpool care pathway for patients who might recover

BMJ 2013; 346 doi: (Published 11 June 2013) Cite this as: BMJ 2013;346:f3702
  1. Martyn J Parker, consultant orthopaedic surgeon, Department of Orthopaedics, Peterborough City Hospital, Peterborough and Stamford Hospitals NHS Foundation Trust, Bretton Gate, Peterborough PE3 9GZ, UK
  1. Martyn.Parker{at}

Death is the inevitable outcome for those on the Liverpool care pathway, so is the use of this pathway appropriate for patients who may have a chance of recovery, asks Martyn J Parker

Having a pathway for all situations is an obsession of today’s medicine. Sometimes this has led to a pathway that was designed for one situation being adapted or used in another—and not always to good effect. This seems to be what has happened with the Liverpool care pathway. It was designed to help those providing care for terminally ill patients who are in their last days of life. The pathway is now being used for patients who may be in their last days or weeks of life but for whom there remains a chance of recovery. Is this appropriate?1

Take for example the case of an elderly woman with a hip fracture. Function declines for many different organs as …

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