60,000 patients put on death pathway without being told but minister still says controversial end-of-life plan is 'fantastic'

Friday, January 4, 2013

60,000 patients put on death pathway without being told but minister still says controversial end-of-life plan is 'fantastic'

Pathway involves the sick being sedated and usually denied nutrition and fluids
Families kept in the dark when doctors withdraw lifesaving treatment
Health Secretary Jeremy Hunt said pathway was a 'fantastic step forward'
Anti-euthanasia group said: ‘The Pathway is designed to finish people off double quick'

By Jason Groves, Daniel Martin and Steve Doughty

PUBLISHED:17:36 EST, 30 December 2012| UPDATED:20:44 EST, 30 December 2012

Up to 60,000 patients die on the Liverpool Care Pathway each year without giving their consent, shocking figures revealed yesterday.

A third of families are also kept in the dark when doctors withdraw lifesaving treatment from loved ones.

Despite the revelations, Jeremy Hunt last night claimed the pathway was a ‘fantastic step forward’.

Outcry: Health Secretary Jeremy Hunt provoked outrage by saying the death pathway was a 'fantastic step forward'

In comments that appeared to prejudge an official inquiry into the LCP, the Health Secretary said ‘one or two’ mistakes should not be allowed to discredit the entire end-of-life system.

But Elspeth Chowdharay-Best of Alert, an anti-euthanasia group, said: ‘The Pathway is designed to finish people off double quick. It is a lethal pathway.

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‘Mr Hunt has made a nonsense of the claim of his ministers that there is going to be an independent inquiry.’

The review follows a public outcry over a string of disturbing cases, highlighted by this paper, in which patients or their families were ignored.

The pathway involves withdrawal of lifesaving treatment, with the sick sedated and usually denied nutrition and fluids. Death typically takes place within 29 hours.

The 60,000 figure comes from a joint study by the Marie Curie Palliative Care Institute in Liverpool and the Royal College of Physicians.

Finished off: Those placed on the death pathway typically die within 29 hours of vital treatment being withdrawn. (Posed by model)

It found many patients were not consulted despite being conscious when doctors decided on their care.

Records from 178 hospitals also show that thousands of people on the pathway are left to die in pain because nurses do not do enough to keep them comfortable while drugs are administered.

An estimated 130,000 patients are put on the pathway each year.

Concerns have been raised that clinical judgments are being skewed by incentives for hospitals to use the pathway.

Health trusts are thought to have been rewarded with an extra £30million for putting more patients on the LCP.

Critics say it is a self-fulfilling prophecy because there is no scientific method of predicting when death will come.

Norman Lamb, the care services minister, launched a review in November, saying there had been too many cases of families not being consulted.

But Mr Hunt yesterday suggested that concerns about the system were relatively minor compared with its benefits.

Fatal: The pathway involves withdrawal of lifesaving treatment, with the sick sedated and usually denied nutrition and fluids. (Posed by model)

Disturbing: A study found many patients were not consulted despite being conscious when doctors decided on their care. (Posed by model)

‘It’s a fantastic step forward, the Liverpool Care Pathway, and we need to be unabashed about that because it’s basically designed to bring hospice-style care to terminally-ill people in hospitals,’ he told LBC Radio:

‘I would be very sad if as a result of something that is a big step forward going wrong in one or two cases we discredited the concept that we need to do a lot better to give people dignity in their final hours because it’s something we haven’t done well.

‘Lots of people don’t want to die with lots of tubes going in and out of their body – they actually want to die in a dignified way.’

He added: ‘What should never happen is that people should be put on to that care pathway without patients being fully in the loop and their families and relatives being fully in the loop as well.’

Controversial: Jeremy Hunt said the death pathway gave the ill 'dignity' in their final hours

The national audit by Marie Curie and the RCP examined a representative sample of 7,058 deaths between April and June last year. The figures were scaled up to give a national picture.

It found that in 44 per cent of cases when conscious patients were placed on the pathway, there was no record that the decision had been discussed with them.

For 22 per cent, there was no evidence that comfort and safety had been maintained while medication was administered.

And it also revealed that one in three families did not receive a leaflet to explain the process.

The LCP system was developed in a Liverpool hospital and has spread across the NHS over the past four years. The review is due to report in the new year.

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Friday, January 4, 2013