Health watchdog proposes new end of life guidelines

Health SUS-150806-142902001
Health SUS-150806-142902001

New draft guidelines have been proposed in a bid to make sure patients across Sussex receive good end of life care in hospital.

The guidelines, put forward by the National Institute of Health and Care Excellence (NICE) – a health watchdog – include making sure patients are well hydrated and nourished before they die.

The new rules will also suggest communication involving patients and relatives in decisions is crucial during care.

A system called the Liverpool Care Pathway (LCP) – which was abolished two years ago – was put in place in hospitals and hospices in an effort to give people comfortable and dignified deaths.

But it faced criticism after some families complained it did not give people basic care – leaving some patients thirsty and deprived of water.

Families also said their relatives had been placed on the Liverpool Care Pathway without their knowledge and others complained it was a ‘tick box’ exercise.

Claire Henry, Chief Executive of the National Council for Palliative Care said: “People need to have meaningful choice and be involved in decisions about their end of life care, allowing them to maintain comfort and dignity until they die.

“That’s why we welcome the NICE Care of the Dying Adult draft consultation, which outlines evidence-based guidelines for the care of the dying adult throughout the care sector.

“However, it is imperative that in order to provide high standards of individualised care and support at the end of life, health and care staff are provided with ongoing training as end of life care is everybody’s business and there is only one chance to get it right.”

The guidelines also cover anticipatory prescribing, the role of assisted hydration, and the pharmacological management of pain, breathlessness, nausea and vomiting, anxiety, delirium, agitation and noisy respiratory secretions.

Maureen Leaver, 83, from East Wittering, died at St Richard’s Hospital in Chichester after a doctor said the Liverpool Care Pathway – which can include the withdrawal of treatment – would be the ‘best option’.

However, speaking at Mrs Leaver’s inquest in November 2013, Dorothy Leaver, her daughter-in-law said the family would ‘never have consented to it’.

Dr Karen Henderson, assistant coroner for West Sussex, said more time should have been given before making the decision to put Mrs Leaver, but she believed the consultant knew Mrs Leaver was dying and wanted to do the best for her.

The guidance is open for public review until September 2015.

Do you have a story to tell about a family member placed on the Liverpool Care Pathway? Do you welcome the draft guidelines?

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