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Compassion must be the key for end-of-life care in Worcestershire
END-of-life care must be about compassion as much as ticking boxes and following instructions, the boss of a hospice in Worcester has warned.
Mark Jackson, chief executive of St Richard’s Hospice, believes the scrapping of the controversial Liverpool Care Pathway (LCP) must lead to a “compassionate culture of care” where patients are treated as individuals by fully trained staff.
The controversial care regime saw treatment, food and water withdrawn from some sedated patients.
But health officials have ordered a complete overhaul of care for terminally ill patients after an independent review concluded that doctors have sometimes used the LCP “as an excuse for poor-quality care”.
St Richard’s Hospice already provides end-of-life training for hospital staff in the county and has now been asked by South Worcestershire Clinical Commissioning Group to extend bespoke training to nursing and residential care homes.
The hospice had previously backed the “appropriate” use of the LCP. But Mr Jackson said: “As this review highlights, providing high quality end-of-life care can never rely on pathways and procedures alone.
"It depends on a compassionate culture of care where patients are treated as individuals, where staff are fully trained and supported, underpinned by effective communication between healthcare professionals, patients and their families.
“Everyone should have access to the best possible care at the end of life, whoever they are, whatever their illness and wherever they are dying.”
Ian Douglas, a consultant in palliative medicine with Worcestershire Health and Care Trust, told Worcestershire’s health and overview scrutiny committee that the LCP had struggled to shake negative misconceptions around sensitive areas such as the withdrawal of fluids.
But he said it had been widely backed by organisations including Macmillan Cancer Support, Marie Curie and Age UK and had been considered beneficial when delivered correctly.
“What went wrong was that the advice and structure was not followed by a small number of professionals, resulting in huge distress to a number of families and possibly untimely deaths in a number of people,” he said.
“It is very difficult to give you assurances that it didn’t happen in Worcestershire, but I certainly have not been involved in a complaint related to the Liverpool Care Pathway.”
The Liverpool Care Pathway was used as part of a wider end-of-life care programme in Worcestershire that is used as an example to health providers in other parts of the country and is in the running for a national award from the Health Service Journal.
Worcester GP Felix Blaine, clinical champion of the programme, believes the programme has made “a really big impact” since its launch in 2008.
Staff across the health service system are better equipped to provide end-of-life care and help people die at home or in hospices, with the number of people dying in an acute hospital setting falling from what was previously a steady 45 per cent to less than 38 per cent.
“One of the reasons we have put so much effort into trying to improve this is because it really matters to all of us,” he said.
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