Compassion must be the key for end-of-life care in Worcestershire

Evesham Journal: Ticking boxes should not be a concern during end-of-life care, says Mark Jackson Ticking boxes should not be a concern during end-of-life care, says Mark Jackson

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The controversial care regime saw treatment, food and water withdrawn from some sedated patients.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.

Comments (5)

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9:12pm Thu 1 Aug 13

BadgerMash says...

Until we all have the right to choose to end our lives legally with dignity at a time of our choosing, talk of compassion in end of life care, although very well meant, is hollow for many, if not most of us.
Until we all have the right to choose to end our lives legally with dignity at a time of our choosing, talk of compassion in end of life care, although very well meant, is hollow for many, if not most of us. BadgerMash

10:41pm Thu 1 Aug 13

rubalish says...

I only wish that the end of my Husbands life in Worcester Royal two years ago had been so different as the way he died will live with me forever .
The lack of compassion and care was dreadful no fluids no mouthwash no pain relief act he did not die with the dignity he so much deserved .To put a dying man on M.A.U was disgusting to say the least , he should have had palliative care and allowed to have his family around him .Not much to ask for was it ?
I only wish that the end of my Husbands life in Worcester Royal two years ago had been so different as the way he died will live with me forever . The lack of compassion and care was dreadful no fluids no mouthwash no pain relief act he did not die with the dignity he so much deserved .To put a dying man on M.A.U was disgusting to say the least , he should have had palliative care and allowed to have his family around him .Not much to ask for was it ? rubalish

9:40am Fri 2 Aug 13

Landy44 says...

I can only speak of one experience at Worcester Royal earlier this year. The nursing staff were for the most part fantastic, and I am very grateful for their caring and supportive attitude and actions.

The statistic that refers to the location of death is misleading. We were given the option to go to the hospice or stay at the hospital. We felt staying was the better option given the circumstances and in the end this was the right decision. I cannot be more positive about the nursing staff we had dealings with.
I can only speak of one experience at Worcester Royal earlier this year. The nursing staff were for the most part fantastic, and I am very grateful for their caring and supportive attitude and actions. The statistic that refers to the location of death is misleading. We were given the option to go to the hospice or stay at the hospital. We felt staying was the better option given the circumstances and in the end this was the right decision. I cannot be more positive about the nursing staff we had dealings with. Landy44

11:49am Fri 2 Aug 13

Name unknown says...

BadgerMash wrote:
Until we all have the right to choose to end our lives legally with dignity at a time of our choosing, talk of compassion in end of life care, although very well meant, is hollow for many, if not most of us.
I wholeheartedly agree
[quote][p][bold]BadgerMash[/bold] wrote: Until we all have the right to choose to end our lives legally with dignity at a time of our choosing, talk of compassion in end of life care, although very well meant, is hollow for many, if not most of us.[/p][/quote]I wholeheartedly agree Name unknown

7:29pm Fri 2 Aug 13

The Moan says...

Name unknown wrote:
BadgerMash wrote:
Until we all have the right to choose to end our lives legally with dignity at a time of our choosing, talk of compassion in end of life care, although very well meant, is hollow for many, if not most of us.
I wholeheartedly agree
I sympathise entirely and have recently watched my father die a very upsetting death on the liverpool pathway. However I also lost my mother to suicide and I can tell you from personal experience I could never agree with allowing someone to end their own life. The truth is that no way of dying is good, but the burden put on someone's conscience to help another to die is the ultimate in selfishness.
[quote][p][bold]Name unknown[/bold] wrote: [quote][p][bold]BadgerMash[/bold] wrote: Until we all have the right to choose to end our lives legally with dignity at a time of our choosing, talk of compassion in end of life care, although very well meant, is hollow for many, if not most of us.[/p][/quote]I wholeheartedly agree[/p][/quote]I sympathise entirely and have recently watched my father die a very upsetting death on the liverpool pathway. However I also lost my mother to suicide and I can tell you from personal experience I could never agree with allowing someone to end their own life. The truth is that no way of dying is good, but the burden put on someone's conscience to help another to die is the ultimate in selfishness. The Moan

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