Amid the recent “media frenzy” surrounding use of the Liverpool Care Pathway there were some “valid points”, British Medical Association representatives were told this week.
Medics at the BMA’s annual representative meeting in Edinburgh admitted that some patients could be left on the controversial end-of-life care pathway for weeks without having their cases reviewed.
There has been intense media scrutiny of the LCP in recent months, prompting ministers to launch an independent review that is expected to be published within a month.
York GP Dr Mark Pickering told the conference some of the reporting had been “hysterical”, but added: “Among the media frenzy there were some valid points: relatives unaware that their family members were on the LCP.
“Senior clinicians unaware that their patients were on the LCP. Patients left on the LCP for weeks without any review or re-evaluation.
“This led to many patients being fearful about end-of-life care.”
He added that financial incentives offered to hospitals to get people on the pathway - a system put in place to reward good practice - risked “a tick-box culture where clinicians may be tempted to feel that the job is done simply by getting the patient on to the LCP”.
Dr Pickering said: “Any end-of-life care tool needs to be used well and any incentives must reward quality and not just quantity.”
He called for better training for medics and a “culture of clear communication” between patients, their families and doctors.
He added there must be a system of accountability to identify poor usage of the pathway.
“The LCP may not be perfect but it can be an excellent tool and if it is used well it will continue to serve the needs of dying patients,” he said.
Professor Baroness Ilora Finlay, a crossbench peer and palliative care doctor, said doctors needed to be aware that the LCP was not a “one-way street”, pointing out 3 per cent of patients put on it do not end up dying.
She told delegates: “The adverse media coverage has affected the care of patients who are dying because patients and their relatives have become terrified that the pathway is a one-way ticket.
“It may well be that the word pathway should be abandoned altogether. The word pathway implies that it is a one way street.
“Yet we know that when patients are managed using this type of guidance about 3 per cent of them get better, so it certainly isn’t a one-way street.”