Is the Liverpool Pathway still being used in our Hospitals

I suppose the advantage we had was that DH's final days were in the hands of the consultant who had been looking after him for six years. Having found a complication that meant he wouldn't survive he stopped all treatment except pain relief and sedation and told me he'd already signed off the DNR because after all he'd been through he didn't want someone trying to start his heart. DH was already out of it but they treated him like one of their family and everyone talked to him and explained what they were doing. DD and I used to sit and chat all day so if he heard anything at all it would be the sounds he was used to at home. After so many years the consultant was as upset as us to have reached the end.

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It is often hard to accept that someone dear has reached the end of their life especially, if it is unexpected and from what starts as a minor problem. There are times when the choice is between endless, eventually futile, treatment that may distress the patient and only extend life for a short period or accepting that the end has been reached and that the best way forward is to let the person just drift out of life peacefully.

I have seen this happen several times in my family and we have at times decided to limit treatment at the end to enable the inevitable to happen quietly and peacefully.

I have also seen patients who are mentally functioning make that same decision themselves; to stop or limit treatment to so that they can die peacefully untrammelled by medical interference.

In over 30 years of being involved in the last illnesses and deaths of my parent's generation and now my own, I have never seen anyone's treatment conducted in a way to hasten death. Sometimes, though, I have almost wished it was possible when someone is dying in pain and distress, despite all the hospital can do to alleviate it.

If anyone thinks their family members treatment contributed to their death then they should pull all the evidence together and make a formal complaint.

RuthMCA I am deeply sorry to read your account of your Dad's death. You and your family must be distraught.

You may be entitled to request access to your Dad's medical records and notes, which may provide you with evidence for a claim for medical negligence. There are specialist solicitors who can help you with this. And of course this won't bring your Dad back, but it would uncover any failings in your Dad's care and may prevent the hospital from doing the same to other people.

Fight for the answers that you and your Dad deserve.

My heart goes out to those of you who have lost loved ones in difficult circumstances.

My own experience of the Liverpool Pathway is with my Mum several years ago. She was admitted to hospital having had a silent heart attack. She had had some form of dementia for a number of years, but was able to live independently, however needed reminding to eat. I told the hospital staff this and they allegedly wrote it in her care plan.

One visiting time I noticed that she didn't have a menu request slip for the following day and when I asked a nurse where I could get one for her, I was told that she had been put on the pathway "ages ago".

Someone took the decision, without consulting any of her family (I was down as next of kin) to put a vulnerable woman with dementia, on the pathway. Consent was never sought. It is of course possible that someone mentioned it to my Mum (as the guidelines say that there should always be a discussion with the patient or family or both), but having dementia she was in no right mind to understand.

I argued long and hard with the staff to try and get the decision reversed. I tried to feed her myself, but she must have had food witheld for so long, that she couldn't tolerate more than a couple of spoonfuls of anything and so couldn't get any nutrition in her system.

Throughout her time in hospital, the 'hands on' nursing staff were wonderful and treated her with care, but they had to slavishly follow the instructions from the higher ups, who held all the power to decide how things would go. They were despicable.

An FOI request in 2012 showed that two thirds of NHS trusts had received incentive payments for meeting targets for using the LCP, and that such payments totalled £12 million or more (source: John Bingham, "NHS millions for controversial care pathway", The Telegraph, 1 November 2012.)

This makes me angry, even after 9 years, to think that Mum was simply a target to be achieved.

The Liverpool Pathway is a disgusting and inhumane process, that is nothing short of legalised assisted death.

Yes the LCP Liverpool ' care' pathway or pathway to death, is still very much alive and kicking today in 2019, in our nhs hospitals, hospices, carehomes and even in your own home by your ' friendly' GP. This disgraced and illlegal ,cruel , practice needs exposing. Please join our facebook page - Nhs hospitals who killed our loved ones.

Just to add something, my sister and I wanted to take our dad home to die and they said he wouldn't last the trip in the car because of the amount of oxygen they put him on, although he wasnt on that much before he went into that room. We contemplated bringing him out and they said he would die on the way to the car park. We should have taken him. His first words when he went into the hospital to us was "im not gonna make it outta here am I girls. Tell all the grandkids I love them".

Hi janeainsworth. I just wanted to say if you look up the Liverpool care pathway u will find out it was brought about in 90's and said doctors could decide which patients were not doing well and actually got 'bonuses' for quickening the dying process. Keeping morphine flowing and decreasing fluids so body will shut down. It was 'abolished' in mid 2000's but did state that is still goes on. When my sister asked the doctor if my dad was on the LCP he said you shouldn't be talking about that. My dad was taken off antibiotics for pneumonia 6 days before he died but that was on his death cert. I just want to make people aware to question everything. I have worked as a carer for almost 13 years and I have cared for many dying patients in their homes and nursing homes. I have given care to those like I would give to my own parents. I would never write anyone off

Alexa thanks so much for your post. I will enquire about PALS xx

Hi silver lining. Thank u so much for your post. I didn't know about PALS. My family and I didn't know which channels to go down. We asked the doctors and nurses what meds daddy was on and they wouldn't give us a list, said they were 'jotted all over his chart. They even took him off all his meds he'd been on for years. I still relive his death every nite as I was alone with him when he died, he was asking if I wanted a cup of tea at 8.55am and I told him to rest.at 9.03am he was dead. I held him until he was cold. I would hate for anyone to go through that. I am now on antidepressants and still can't function. We just want answers. You put your lives in doctors hands. My dad didn't deserve it. He worked since he was 13 years old and over the years 60-70 hours a week. Paying so much tax and now he's gone. I just don't want it happening any others loved ones. I will enquire about PALS and my dad's records. We still just coming to grips with it. But thank u so much for your post x

Hi gillybob, thank you so much for responding. My dad had a leaky heart valve and had heart attack and stents put in 5 years ago but apart from that he was good. He was admitted for the pneumonia. I don't understand because half way through his 2nd wk in hospital they said they stopped the antibiotics for his pneumonia but that's what his death certificate stated as cause of death. I think the liverpool care pathway is still in place and people should be concerned for their loved ones. The hospital was so quick to write my dad off as soon as they put him in the solo room. I trusted the health system but now I don't. Anyone reading this read up on the liverpool care pathway and ask more questions. Thanks for us post x

Gillybob and Tina, I had hoped that my experience of negative help from PALS was unique. Now it seems that PALS may not be a lot of use as an enabler of communications.

gillybob that sounds as perfect as a death can be, well done to your family for making it so, brought a tear to my eye!

My mum had a “good calm death at home” notanan2. We sat by her bedside for over a week and she chatted and listened to her favourite music, my grandchildren visited and behaved in exactly the same way they always did each jostling to get prime position desperate to tell her their special news, she was so happy, right up until the end . At midnight I drove my sister and I home quickly to get showered leaving my dad snoozing beside her and she slipped away .

anything can be missmanaged, that doesnt mean the thing itself is bad/wrong.

Surgeries can be inappropriate & missmanaged: that doesnt mean that hospitals are wrong to perform surgeries in general.

Same for end of life care plans.

It's a good thing that there are best practice standards for the care if dying people.

If anything I think there are a lot of people in the UK who feel that we dont consider that option until too late: often missing the window for a "good" calm death at home or in another place of choice.

I disagree with your words and your views Tina. My experience and that of so many loved ones has been a million miles away from the one you describe.

Lived it now for the past 18 months with proof in Black and White - Bitter? -no just experienced!

Sweeping generalisation there, Tina.
You sound very bitter.

Yes unfortunately they are part of the circle of conspiricy to silence so for that matter is the Ombudsman unless your rich you have no recourse to these people we all pay to care for others!

Meant to add, not the ambulance personnel themselves but the service coordinators.

PALS forget it the only thing you need to get to the truth unfortumately is a very large Bank balance

I agree with you about PALS Tina3120

I had an occasion to complain about the ambulance service when my late mum was on dialysis and was directed to PALS. They were completely unsympathetic, useless even and I felt that we were being patronised and read to from a previously prepared speech.

Understandable but not the kind of deaths we are talking about its when Treatment is with held or delayed long enough to cause secondary problems or no treatments given at all for diagnosed issues with no explanation other than "theres no point in it" which is what my family was told my Mum was having a cut and blow dry in the hairdressers on the Sunday and DNR placed on her by the Wednesday!

According to the news there has been an unexplained increase of 20,000 deaths so far this year

if you remember the news from earlier in the year there was a massive surge in hospital admissions and a national bed shortage so a higher death toll this year is to be expected this year.

And vaccine uptake is down. Antibiotic resistance is up.

Yes It would be good but that would bring all to light and if this is a training thing whats gone wrong? Many years ago no one worked on a ward until they were qualified to do so no responsibility and no supervision is the biggest problem

My heartfelt sympathies for those who have experienced what they feel is needless suffering and death. According to the news there has been an unexplained increase of 20,000 deaths so far this year. I imagine a large part of the reason is the shortage of properly trained staff and resources. It would also be interesting to have the figures broken down by area/hospitals. I live on the border between two counties and friends receive very different treatment in the different areas.

It is frightening to think about what happens to people who have no one to look out for them.