This story was first published in digitalhealth.net
Doctors should deliver better end-of-life care, NICE urges
It advised patients must be treated with respect and compassion, and doctors should avoid making ‘snap decisions’ about whether a patient is dying.
The new guidance has been issued to address the misuse of the previous Liverpool Care Pathway (LCP) system. The old model was introduced in the late 1990s, in an attempt to ensure people had a dignified and comfortable death.
The system involved checklists which prompted staff to consider whether invasive procedures such as drips and drugs should be withdrawn from people in the last stages of life. However, the practice was phased out last year after a government-commissioned review revealed serious concerns that it was being used incorrectly, leading to a ‘tick-box’ culture.
Such concerns regarding the LCP saw instances where some patients were left without food and water.
NICE’s new guidelines calls for a stronger focus on individual plans for each patient, instructing that the wishes of the patient and their family should be central.
Professor Sam Ahmedzai insisted this could only be achieved by a change in attitude to ensure staff had more respect for care of the dying.
He added: ”You have to look at each individual person and respect them as an individual person, ask them about their wishes.
"Some people may want interventions, may want tests to carry on. Others may want to stop all those things. Some people may want fluids, others may not want fluids. So respecting the individual and not having a one-size-fits-all approach."
Lord Howard, chairman of Hospice UK, welcomed the guidelines but said there would be real challenges putting them into practice.
He said: ”There can never be 'a tick-list approach' towards caring for the dying and this guidance must be underpinned by greater investment in training and education for all staff involved in end-of-life care.
"This is crucial if we are to avoid the failings of how the Liverpool Care Pathway was implemented.”
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