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Non-palliative care staff need to deliver generalist end of life care

BMJ 2014; 348 doi: (Published 20 May 2014) Cite this as: BMJ 2014;348:g3426
  1. Leeroy William, palliative care specialist, Monash Medical Centre, Monash Health & Box Hill Hospital, Eastern Health, Melbourne, Australia, and adjunct senior clinical lecturer, Monash University, Melbourne, Australia
  1. leeroy.william{at}

Leeroy William reflects on end of life care from Australia, one of several countries where the Liverpool care pathway is still in use

The recent demise of the Liverpool care pathway (LCP) in England has shocked many healthcare professionals. There had been poor use of the pathway in the beleaguered English NHS, and similar controversies could occur in any of the 21 countries still using it,1 or anywhere using a derivative of the pathway. How did this model of end of life care—perceived as best practice—fall from grace?2

The LCP was developed in the late 1990s. It aimed to transfer the hospices’ approach to end of life care to people dying in other settings. In 2013, however, in the aftermath of media fuelled criticism, the UK government commissioned an independent review. The panel’s report, More Care, Less Pathway, made comprehensive recommendations, including the phasing out of the pathway within a year.3 With or without a …

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