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To ask the Secretary of State for Health what steps his Department is taking to ensure that patients and their relatives are informed by clinicians when hospital trusts are placed on the Liverpool care pathway.
The Liverpool care pathway (LCP) was developed by the Marie Curie Palliative Care Institute in Liverpool as an approach to support the delivery of good care in the last days of life. The Department of Health is not responsible for the LCP, but recommends it as good practice.
Before putting someone on the LCP, senior doctors and nurses involved in the patient's care should agree that death is very likely to be imminent and that being placed on the pathway will be beneficial to the patient. The LCP documentation is clear that a decision to use the pathway should always involve the patient and/or family members.
The National Care of the Dying Audit—Hospitals, based on the standards of care within the LCP and run by the Marie Curie Palliative Care Institute in collaboration with the Royal College of Physicians, assesses the use of the LCP and the quality of care provision. This audit is one of those that must be reported in providers' Quality Accounts.
The report of the third round of the audit notes that in 94% of documented cases discussions explaining the use of the LCP were held with relatives or carers. However, as part of the report's recommendations, it stresses that the decision that a patient is dying and in the last hours or days of life should be discussed with patients, where appropriate, and always with relatives or carers.