A CONTROVERSIAL end-of-life care regime is to be scrapped after a review founded the need an overhaul in the care provided for dying patients.
The Liverpool Care Pathway (LCP) system was designed to allow the terminally-ill to die peacefully and with dignity but is now to be phased out over the next six to 12 months. It will be replaced with a personalised end-of-life care plan for each individual patient.
The Scottish Government said the review recommendations will be considered by its Living and Dying Well National Advisory Group, Scotland's first national action plan for the provision of palliative and end-of-life care, "so any learning for Scotland can be taken forward with stakeholders".
LCP came under criticism with some believe it is being used to speed up the process of dying. There have been some reports of patients being put on it without consent and not being allowed, food, fluids and medication.
A Government-commissioned review, headed by crossbench peer Baroness Neuberger, concluded the pathway, which can involve the withdrawal of food and treatment, was being "misused".
The Scottish Partnership for Palliative Care said the review report was a "welcome opportunity" but said it was important none of the improvements which have been achieved in recent years were lost.
Mark Hazelwood, SPPC director said: "There is a lot of very good care provided for people who are dying in Scotland, but it is vital to ensure everyone receives such care."
Niall Dickson, chief executive of the General Medical Council (GMC), welcomed the review adding: "The UK has led the world in pioneering the care of the dying and we have some of the most skilled and dedicated doctors, but we do need to make sure good care is practised everywhere.
"As for doctors who fall seriously below that standard, they are putting their registration at risk and we will look carefully into any specific cases highlighted in the report."
Doctor Des Spence, who practises in the Maryhill area of Glasgow added: " It's a shame they had to abolish it but when you hear how it has been implemented then I think there hasn't been any choice, really."
However, the move has been criticised by some including Glasgow-based medical commentator Dr Margaret McCartney who has felt the LCP had suffered an "onslaught of scaremongering" and it is being used as a "scapegoat on which to blame bad care, inadequate staffing levels, or poor communication".
"We have to stop blaming a pathway, and start talking about what enables and what distracts staff from providing good end of life care," she said.
"It isn't about more paperwork – it's about allowing staff to fulfill their professional roles and resourcing them enough to allow this."
The review heard hospital staff wrongly interpreted its guidance for care of the dying, leading to stories of patients who were drugged and deprived of fluids in their last weeks of life. It found it was not the pathway itself but poor training and sometimes a lack of compassion on the part of nursing staff that was to blame, while junior doctors were expected to make life-and-death decisions beyond their competence after hours and at weekends.
The review says individualised end-of-life care plans must be drawn up for every patient nearing that stage.
Last year, Lothian and Borders Police were urged by the son of one elderly patient, 83-year-old Jean Tulloch who died to investigate the LCP after she died at Western General Hospital in Edinburgh.
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