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Liverpool Care Pathway Review 2013

Liverpool Care Pathway Review

The UK Government announced in 2013 an intention to phase out use of the Liverpool Care Pathway (LCP). The report of the independent review found flaws in the way the LCP was used, including poor implementation and concerns regarding the standard of care. Other publications by the UK Department of Health about the review can be found at:

Recommendations of the review included:

  1. phasing out the LCP and replacing it with an individual end of life (EoL) care plan
  2. a general principle that a patient should only be placed on the LCP or a similar approach by a senior responsible clinician in consultation with the healthcare team
  3. unless there is a very good reason, a decision to withdraw or not to start a life-prolonging treatment should not be taken during any ‘out of hours’ period
  4. an urgent call for the Nursing and Midwifery Council to issue guidance on end of life care
  5. an end to incentive payments for use of the LCP and similar approaches
  6. a new system-wide approach to improving quality of care for the dying

Queensland Department of Health Response:
Queensland's Dept of Health then considered use of EoL care pathways in Queensland and on 9 Aug 2013 sent a memorandum to all Hospital and Health Service (HHS) Chief Executives indicating:

In Queensland, a number of EoL clinical pathways have been developed based on the LCP. There are however key differences between these and the LCP:
1. Importantly, there are no financial incentives for use of EoL clinical pathways in our public hospitals.
2. It is expected that staff only use the LCP after appropriate training to ensure pathways are implemented ensuring good quality palliative and EoL care, recognising individual patient choices and that pathways are not intended to replace clinical judgement.

The Department recommended the review report be made available to relevant services provided by and for each HHS to consider what, if any, changes may need to be made to any relevant clinical pathways, clinical governance oversight and audit processes.

Last updated: 12 January 2015