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Liverpool care pathway is scrapped after review finds it was not well used

BMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f4568 (Published 16 July 2013) Cite this as: BMJ 2013;347:f4568
  1. Nigel Hawkes
  1. 1London

The Liverpool care pathway for patients needing care at the end of life, though well intentioned and often admirably carried out, should be scrapped in favour of individualised care plans, says an independent review immediately accepted by the UK government.

Too often, the review found, the pathway was applied with a lack of expert knowledge and care, its advice turned into a set of rigid instructions by staff who had not been properly trained.1 Its very name suggested that it was a pathway with only one possible destination, “a conveyer belt to death,” it said. Hospitals were rewarded financially for using the pathway, creating the impression that they were hastening death for financial gain. All this must change, the review concludes.

The review, chaired by the rabbi and peer Julia Neuberger, makes few direct criticisms of the pathway itself apart from its name. In the right environment, and with the right staff, it had enabled many people to have a better death than might otherwise have been the case. But the team heard evidence that “disturbed and upset them,” Neuberger said, that while it might be good guidance it was not well used. The review concludes: “The Liverpool Care Pathway …

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