Intended for healthcare professionals


The Liverpool care pathway: a cautionary tale

BMJ 2013; 347 doi: (Published 31 July 2013) Cite this as: BMJ 2013;347:f4779
  1. Katherine E Sleeman, clinical lecturer in palliative medicine1,
  2. Emily Collis, consultant in palliative medicine2
  1. 1King’s College London, Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, London SE5 9PJ, UK
  2. 2Pembridge Palliative Care Centre, Central London Community Healthcare Trust, St Charles’ Centre for Health and Wellbeing, London, UK
  1. katherine.sleeman{at}

Its fate should serve to warn us of the dangers of implementing tools that are not properly evidence based

After a six month independent review commissioned by the minister of state for care support, Norman Lamb, a series of recommendations has been made to improve end of life care in England.1 The review, led by Julia Neuberger, was prompted by press reports of poor end of life care associated with the Liverpool Care Pathway for the Dying Patient (LCP). The review panel concluded that in the light of numerous accounts from bereaved family members of poor care associated with the LCP, and without strong evidence of the pathway’s potential benefits or harms, use of the LCP could no longer be justified. The panel recommended that the pathway should be phased out, and replaced within six to 12 months by individualised care plans and condition specific guidance.2

If used appropriately, the LCP can provide a model of good practice for the care of dying patients. However, undoubtedly some patients have received poor care in association with the pathway. The review panel was told of many experiences where communication …

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