Plan for end of life care branded ‘underhand’

LOTHIAN health bosses have been branded “sneaky” and “underhand” after it emerged that they had discussed “rebranding” controversial guidance for providing end of life care.

Use of the Liverpool Care Pathway, which sets out guidelines designed to ensure people are comfortable in their final hours, can see nutrition withdrawn from dying patients and has attracted negative publicity following fears it is adopted as a way of bringing in “euthanasia by the back door”.

And with the Liverpool Care Pathway protocol being rolled out across NHS Lothian, it has emerged that influential health chiefs have mooted changing its name to the Lothian Care Pathway when it is used here.

Morag Bryce, a member of the NHS Lothian board and the chair of its Healthcare Governance Committee, admitted those close to patients had become concerned about the pathway. Ms Bryce said: “There has been significant media coverage which has worried families and carers.”

The possible name change was discussed at last month’s Healthcare Governance Committee, but NHS Lothian said today that it currently has no plans to rebrand the pathway.

Dr Jean Turner, a former anaesthetist and director of the Scotland Patients Association, said she believed it made the health board appear “sneaky”.

“They are underestimating the intelligence of the public,” she said. “The Liverpool Care Pathway is excellent when used appropriately – I noticed to my horror that people think it’s a form of euthanasia. But the answer is to make people understand what it is.

“Changing the name would be a bit underhand. This will just make people think the NHS really are trying to bump people off.”

Peter Tulloch, whose 83-year-old mother Jean was admitted to the Western 
General Hospital with a urinary tract infection, alleges that on one visit he found her intravenous drip had been removed.

After he raised concerns in March last year she was taken off the Liverpool Care Pathway, but died two weeks later.

In the six months to the end of August last year, the Liverpool Care Pathway was adopted for 616 patients in Lothian hospitals and in a 12-month period, it was implemented for 293 other patients in the community. Of the hospital patients, 28 were later taken off the pathway, while seven survived.

NHS Lothian is set to launch an information campaign, while its leaflet, called What Happens When Someone is Dying? is being reviewed.

Dr David Farquharson, NHS Lothian’s medical director, said: “We are aware of the importance of communicating with and supporting people whose relatives are in the last days and hours of life.

“Discussions with a patient’s family are vital and it’s important to ensure they are included in the decision-making and care plan and that they understand that it is being considered so that their loved one can be given excellent end of life care.

“The decision to consider end of life care is always taken by a senior clinician and the medical staff involved in the patient’s care. This information is recorded within the Liverpool Care Pathway document.

“We strive to continually improve the quality of end of life care and as part of this we are reviewing the current information leaflet. This involves carer groups to ensure the information provided meets the needs of families and carers.”