Dying in hospital and the Liverpool Care Pathway

There has been a great deal of press interest recently in the Liverpool Care Pathway for the dying patient (LCP). It has been described in more colourful language, which I will return to later, but I should start out by explaining what it is – and just as importantly what it isn’t.

The LCP was developed in the late 1990s by a hospital in Liverpool and a local Marie Curie hospice. The aim was to bring high-quality hospice care for cancer patients to hospital settings. Later, this was expanded to non-cancer patients and has been adopted by a large number of hospitals throughout the NHS and other countries.

Why was (and is) this necessary? Modern hospice care emerged in the 1960s out of a desire to improve the experience of dying for terminally-ill patients. Hospitals are traditionally very good at delivering curative care, but do less well at caring for people whose greatest need is to be as pain-free and as comfortable as possible, and to have the reassurance that their families are supported to prepare and come to terms with a loved-one passing away.

The reality today is that the majority of people are in hospital when they die.  Though the circumstances may vary – for example they may have been recently admitted as an emergency, or they were being treated for an illness that they may not recover from – past reports have shown that poor experiences can be very similar.

These poor experiences tend to arise because their healthcare team has not identified that they may die in the next hours or days; their care is not being planned appropriately; families are not provided with emotional, spiritual and practical support. Resolving these issues can even mean someone doesn’t need to be in hospital at all, allowing them to die at home which is frequently preferred.

The LCP sets out to support hospitals to address such issues. It describes well-tested best practice around the care of dying patients and encourages hospitals to improve their wider work and training in end of life care.

What LCP doesn’t do

What the LCP does not do is give hospitals a license to hasten death. It does not recommend withholding food and water, and putting someone on the LCP is not irreversible. Patients should be reviewed every 4 hours and fully re-assessed every 3 days or in response to a number of triggers.

The LCP explicitly says that families and carers should be fully involved in any decisions around a person’s care.

Age UK firmly believes that where the LCP is properly implemented, it provides some of the highest standards of end of life care. However, we are concerned that a number of people have reported inappropriate use of the LCP, or care that does not live up the standards it describes.

In fact, many of the issues being reported fall within the poor practice described earlier that the LCP set out to resolve. One of the more distressing examples that keeps emerging is families only finding out that their relative is on the LCP after they have died. This shouldn’t happen under the LCP and it certainly shouldn’t happen in a compassionate NHS.

No quick fix

It is important to recognise that the LCP isn’t a quick fix. There are deep issues with how health services care for people at the end of life, and we hope that any light shone on the use of the LCP also brings out some of the more endemic failures around delivering well-planned, dignified care for older people at any stage of life.

Our work with NHS Confederation and the Local Government Association on a commission looking at dignity in care mirrors many of the complaints we are hearing around the improper use of the LCP. It would be naïve to believe the issues are not linked.

Talking about death and dying is extremely difficult and it doesn’t necessarily get any easier if you are a doctor or nurse. Unhelpful language such as “death pathway” or describing best practice incentives as “financial rewards” for ending life do not advance the debate.

While we must recognise and investigate the very real issues raised by such media reporting, we must not be frightened into thinking that good end of life care is avoidable or unnecessary. The need for it is inevitable and for it to be good is vital.

Any older person or those caring for them who needs further information about resolving problems with NHS services can contact Age UK’s freephone advice line on 0800 169 6565

Find out more about Age UK’s policy work on health and wellbeing 

Author: Tom Gentry

Policy adviser - health services @tomogentry

37 thoughts on “Dying in hospital and the Liverpool Care Pathway”

  1. A difficult subject as has been said.
    I am concerned that there seems to be an implied belief that Marie Curie Care is,in some,way,less than it might be because of the involvement with the Pathway project. LCP

    I hope that this possibility will be fully examined

    1. bless youl, I dont think us oldies are daft Kate! We know what ‘terminally ill’ means, having watched people suffer with the final days of cancer in agony in the 40’s and 50’s with no help with pain. But you have to be aware, lots of us have seen friends and partners go into hospital with conditions that are not terminal but need long term treatment. only to be lied to about it, then find they’ve been unconcious and find what they call ‘terminal sedation’ or ‘palliative sedation ‘ has been used on them, until they died. 120 at the Gosport War Memorial Hospital – nowt ‘terminal’ about any of them..and that was before the LCP formally ‘allowed’ doctors to do it too….

      1. DIRECT WITNESSES, that is the families who ‘saw’ with their own eyes how LCP are the ones to harken. Not the vast majority of others commenting ‘without experence’ or because somehow their job is connected to the NHS. It might be “OK” from where you are placed. Fine, move on. But for those families who were present, ignored, not consulted at all with doctors and nurses signing papers for DNR and LCP without saying a word to families standing around a dying person’s bed is what happened to me. That is wrong. The machines of government are at present behind closed doors, changing the semantics “what it is” and “what it isn’t” being banded around. More relevant LCP is not a law and it should be. It should have the dying or/and near one’s signature and electronic records (not hand written) with each paid nurse and doctor listed and it should say LCP on the death certificate showing the degree of sedation and morphine used. Cold statistics must be revealed. They are weak and it should be revealed whether the LCP org (whoever and wherever they are hiding) are supervising the data. If 33% are LCP deaths and 77,000 die this way per year (recent National Audit Office recalculation) – is that only in England and Wales.
        Comments are fine but careless thoughts without precise, backed up statisical data is, guess what, missing. The LCP is ‘allowed’ to be used by our Government. Who is ‘allowing’ it, given it was developed for use for CANCER patients. Who has extended it use? Who ‘allows’ it to be used while deliberately avoiding proper family consultation. My case will live with me for the rest of my life. It happened without clinical judgement given to us and with medical records missing for 6 months. Please do not comment when ‘you are in a comfortable position’. Consider those who have direct experienced the LCP in such a covert underhand manner. Please do not comment if you are connected to the health industry and have NOT been in this situation. The LCP must be banned. Look at other countries. Make a law!

      2. Having looked up Marie Curie’s entry at the Charity Commission and seen that they spend more of their income on salaries for execs. and fundraisers than they do on front line nursing staff, I’m afraid I’m no longer their biggest fans. And why Age Concern are still supporting this pathway, I dont’ know.

        McM were told the LCP documents were totally flawed way back in 2008 (the v.8 gave nurses the impression they could administer lethal doses without consent, even if the patient wasnt in pain, and whether the patient consented or not !!! they were so badly written!!) Rather than do an urgent recall and retraining, the Dr at the top and his chief nurse just carried on going all over the world on free trips and conferences –
        When I say ‘free trips’..they were paid for with the money raised by people with cancer . 130 000 old people have been finished off with drugs BEFORE THEIR TIME….like we’re taking too long to die nowadays.!
        Macmillan can make a Hattie Jacques-thermometer out of their Daffodil Day badge this year as far as I’m concerned.
        Age Concern insurance (DAS) doesnt cover the cost of an Inquest for those killed by ‘mistake’ on the LCP by the way.. ….and they arent keen on even paying for a medical negligence casea if the victim was over 65….so why are you still using them???????

  2. Lots of people have had those very poor experiences that you have talked about and lots of people have had their deaths hastened. I managed to intervene in my brother’s care and he went home. Other people were revived so clearly they weren’t ready to die. This is why distraught relatives are contacting the newspapers, BBC, MPs and anyone else who will listen to the truth. I’ve ben a nurse for nearly forty years, I want a comfortable death but I want to go when it is really time to go. Predicting death is not an exact science even when someone is very ill, I know this. Be compassionate and listen to the stories of these people, they don’t want money they want to stop this happeningto others. They want the medical and nursing professions to stop being so arrogant and right. Take a step back be empathic and look through someone else’s eyes, please.

  3. It was brought to my attention that you signed up to the Liverpool Care Pathway back in September 2012 and I have sent a lteter to Michelle Mitchell.

    I was wondering whether you have been made aware or knew about the number of cases of patients who were NOT terminally ill, who without any reason, have been placed on this pathway and without the knowledge of their families?

    You might think that the people who have come forward to share their stories have all jumped in on the bandwagon, but no, they are all genuine grieving relatives, like me, who are deeply upset because they feel they have been duped into thinking that the Liverpool Care Pathway means their loved ones are being looked after because they are terminally ill. In many cases where relatives have been more informed about LCP that they have forced doctors to re-think and reverse the pathway procedure and these loved ones have then recovered. I wish I knew then what I know now as I might still have my dad with me today.

    The generic Liverpool Care Pathway procedures state that there are four main conditions a multi-professional team have had to agree to under which a patient would be committed to the Liverpool Care Pathway which are:
    • The patient is bed bound
    • Semi-comatose
    • Only able to take sips of fluids
    • No longer able to take tablets.

    However many relatives have stated that their loved ones died because they were selected by doctors who had not consulted with them and had not referred to these conditions.

    It has since emerged that there are payments to NHS Commissioners for fulfilling their targets and these are called CQUIN payments (Commission for Quality and Innovation) and these payments could be seen by some as an incentive to put a patient on the Liverpool Care Pathway in order to receive the funding, often to ailing hospitals.

    It is all very well to eulogise what SHOULD happen but there are several pages on Facebook of families and relatives who have had BAD experiences. So do you really feel confident that you are happy you are in with the right organisation (LCP) because I have to say when this explodes (and I leading a campaign to stop the misuse) I would not like to be in your shoes. I welcome your reply….. I lost my dad through being on the Liverpool Care Pathway when he was not terminally ill. Put yourself in my shoes and think how you would feel if it was your dad.

    Yours sincerely

    Denise (this is a copy of a letter I sent to Michelle)

    1. As you say Denise, some appear to be jumping on the bandwagon. Since reading of the Liverpool Care Pathway experiences, both good and bad, I was lucky to have taken the steps I did and not approach any media at the time it happened to me in 2005. I advocate to anyone who believes an untoward event has happened within a hospital setting to obtain all medical notes before seeking publicity. Before any publication can proceed the press or TV have to contact the defending Trust to obtain both sides of a story. In doing so the Trust have been put on high alert that a forthcoming complaint is imminent and all incriminating evidence CAN get lost, stolen or destroyed.
      When my late beloved, in absence of any cancer, entered Professor Pullicino’s Trust for what should have been a routine day surgery biopsy, suffer a post-op respiratory arrest, spend 3 days in ITU and die 3 weeks later from supposed LUNG cancer I thought I would, at least, unequivocally prove a late cancer diagnosis.
      Instead, it took 4 years of the “Kafkaesque” NHS complaints procedure and 2 Independent Reviews by the Healthcare Commission for their clinical expert to conclude that, from the CT scans and chest x-rays provided by the Trust, there is no definite evidence pointing towards a LUNG cancer?
      Every solicitor declined my case on the basis that any compensation for a late diagnosis of lung cancer, due to its poor 5 years survival rate, on which compensation is awarded would be cost prohitive.
      An independent medical report confirms that the lung nodules were actually pulmonary embolisms mistaken for cancer. Due to the MISDIAGNOSIS my darling had a DNR order placed within her notes and beneficial respiratory medication and anticoagulation was withdrawn and a Morphine syringe driver, with Midazolam and Cyclizine was surreptitiously used to hasten death.
      Fair enough, mistakes happen, but when the Trust’s complaints department conspire to conceal the true cause of death by deliberately refusing a post mortem and fabricate events with the immediate relatives that they had no contact details for is beyond contempt. I will continue to expose those responsible that should have just raised their hands and said “sorry, on this occasion, we got it wrong”.
      Don’t forget to watch Newsnight on Monday 26th November.

    2. Well done Kathleen. Spot on. But I dont know how to work these email thingies. I want to join your campaign but don’t know how to reach you (in March 2013). Do you know that “Dying Matters” is taking all the relatives LCP complaints but “Dying Matters” is the lead charity of the Palliative Institute (NCPC?) supporting LCP!!! 22 charities and orgs, inc Age UK got together supporting the LCP a month or two ago in readiness BEFORE the chair for the LCP Review was announced on 15 January 2013 =- when Rabbi Baroness Julie Neuberger, was appointed ‘chair’. She is said to be very very supportive of the McMillan nurses who helped so much with her father. That’s not being neutral and independent! Will someone out there who knows how to do emails and research please check these TWO very valid points as the Review would have started to collect relatives complaints since the chair has been appointed. Which org is channeling relatives’ LCP complaints in their direction – and how? If Dying Matters and the chair of the LCP Review are already ‘with’ the 22 orgs and charities (in the recent NHS Constitution? Confederation?) then relatives cannot expect a fair deal and may be further ignored. Will someone alert do the sharp end of this research. The relatives complaints and paper work could go missing and thereby the numbers of complaints will be minimised. It will be a further abuse which must be nipped in the bud immediately and hopefully after a harmless, open, transparent check, all will be affirmed with ‘candour’ as ‘neutral’ and ‘independent’. Can Ann Reeve in Gosport do a Freedom of Information on this? On your marks, girls and boys. To the rescue, all of you, please – for our loved ones. We won’t let them get us down. xoxo. m

  4. An abhorrent and disgusting way to treat any human. Such a process would be illegal if administered to any other animal.
    There is no way that anyone in their right mind could justify this as an appropriate way to end a life.
    I had to watch my father being starved of food and water for 7 days. I know how distressful this was for me and my relatives to watch. I couldn’t even imagine how stressful this must have been for my father.
    I am not arguing against end of life treatments for the terminally ill, but as a society we must open the debate on significantly more humane ways of doing this.
    This is ‘disguised euthanasia’ endorsed by the health service and successive governments. If euthanasia is the right thing for the patient and society, then lets have the debate and look at ways where this can be done humanely. It is the height of hypocracy for those who protest morally against euthanasia and do nothing about this abhorrent national policy.
    If we took away the name ‘Liverpool Care Pathway’ and call it what it really is ‘Starvation’, then there would be a national outcry.

    1. I note the moderator on this website is not allowing any criticism of Dr Natalie’s lack of experience in this matter….she only qualified in 2010, yet is Age Concern’s ‘Expert’….lots of old codgers know what goes on with this pretence of a ‘care pathway’….so sorry for you and your family ….

  5. My dad entered a Marie Curie Hospital in Hampstead for the last month of his life in 2007. Before that he was in UCH on the Euston Road. The difference in care he received in the hospice was incredible and I would argue it was a much better place for him to be than in a busy hospital ward where the nurses and doctors had little time for him.

    The doctors and nurses at the hospice did not discuss the Liverpool Care Pathway procedures with us but when he was admitted he was bed bound, semi comatose, only able to take sips of fluids and tablets were administered via a band on his arm which appeared to be automatically injected straight into the blood stream.

    Reports seem to be suggesting that many relatives have stated that their loved ones died because they were selected by doctors who had not consulted with them and had not referred to the Liverpool Pathway conditions.

    It’s a hard call in my mind, having gone through this painful time with my dad I prayed for the last few weeks of his life for him to be taken out of his misery. Having said that though these latest reports have put some doubt in my mind that my dad was necessarily ready to go at this time. Maybe so, maybe not! However, one thing I am sure about is that he was suffering and, whether he went before his time or not, he isn’t suffereing anymore. I will always stay committed to the belief that Marie Curie did everything they could to make the end of my father’s life more comfortable and certainly helped prepare the family for his final days and the months to come.

  6. My ex-wife died recently she had cancer of the brain and lungs , it began in November last year in feb this year she had chemo and a couple of weeks later radio therapy it weakened her so much she ended up in a wheelchair to get about it was painful to watch her slow decline the hospital [arrow park , Clatterbridge] kept sending her home even after me telling them she lived alone in a 3 bed house and was unable to reach the bathroom to do toiletry business I complained to PALS which are supposed to sort complaints between staff and relatives visiting patients , they told the people they are only allowed to liaison with her next of kin , me being divorced from her did not count which is rubbish its obvious PALS is run by the staff there so their bound to put people off complaining , while at home she was found on the ground in her backyard by a neighbour if he had not seen her she would died there I told both hospitals about this and all they said was lack of room to accommodation her or staff to cope even on her last night there the doctor called me into a side room to tell me the obvious she will pass soon , peculiar because we informed 3 weeks earlier she was all clear which i did not believe for a minute no one i know has survived brain and lung cancer but I said nothing for my daughters sake who was taking badly they were very close I could see they kept her dosed many times I visited she slept right through my visit which was upsetting , at one time they rang to to come [arrow park] to come and take her home was 11am I gave them an hour and a half to sort things out got there about 2pm we were there till 8.30 , all they would say was be patient every time i asked whats the hold up , there is a lot to be said for having a nice big heart attack and gone , this happening to everyone up and down the country its a disgrace that the only way to get treated with respect is bwhen you pay for treatment .

  7. I was recommended the Liverpool End of Life pathway at the end of my husband’s life and though I was dubious at first at stopping all his tablets and just treating symptoms, it was the right thing to do.There was a full discussion between me, the Dr and District nurse.I was phoned daily by the Macmillan and Marie Curie Nurses.He could have what food and drink he could manage and did not suffer. he died peacefully at home in his sleep without morphia.He had an aggressive skin cancer and underlying severe stroke. I think the problem is when the Guide lines are not followed properly, especially in hospital and it is not discussed fully with the relatives

  8. You only graduated in 2010 Natalie – your claim to be an ‘Expert’ sounds a bit far-fetched – would much rather take medical advice from wiser heads like Professor Pullicino..there’s a ‘proper doctor’ for you ! Too busy with his patients to run a ‘Twitter’ page like you do….

  9. You are the epitome of the arrogant medics we try to speak to in hospitals and so on….full of yourself mainly. The Liverpool Care Pathway is a way of killing a patient by witholding the treatment they should get and giving them an overdose to kill them. If it is ‘reversible’ Doctor Natalie…I challenge you to let us put you on it , and let me decide how much morphine ‘prn’ really means ….

  10. I don’t see that any ‘care pathway’ installed into the NHS should include the option for a practitioner to inject a lethal cocktail of drugs – which this one does. It says the relatives will be asked, but the law allows some money grubbing medic to just ignore what they want and fire ahead anyway. Senior Citizens are ALWAYS ignored by doctors…… We looked you up at the General Medical Council Dr Silvey, and see you only graduated a year ago……hardly an ‘expert’ are you…..just want to be in the newspapers really. I think Age Concern should be more careful about allowing what is basically a student to give medical opinions on its web pages…

  11. I really don’t think the ‘problems’ are as trivial as you suggest, and Denise is totally correct – they have been ‘rolling out ‘ this ‘care pathway’ for nearly a decade now, and if they haven’t ‘got it right ‘ by now, they never will. In a palliative care setting, according to the British National Formulary – it is OK to prescribe really dangerous drugs like morphine and midazolam at ABOVE the safe, licensed doses – the LCP leaves it to the ‘clinical judgment’ of the nurse how much to administer – who is checking the amounts they are using???? Safe doses??? Overdoses??? Deliberate overdoses??? There is no audit data of this on the LCP site at all! There have been too many reports of people being given these ‘terminal pain’ drugs when they has been no pain whatsoever that the LCP has caused huge mistrust of the medical and nursing profession. I’m sure that rather than alleviating suffering and indignity a huge amount of suffering and misery has been CAUSED by the LCP, and the Department of Health should suspend it and hold a Public Inquiry immediately. My own father’s sudden lapse into a coma and death 3 years ago now looks mighty suspicious to us, and I’m sure we are not alone.

  12. Please note that ‘Dr Natalie’ did not write this blog or contribute to it in any way. This blog was written by Age UK’s policy team.

  13. My brother died in a Marie Curie Hospice and my sister-in-law died six weeks later in a different hospice. Families are not consulted at all. It is a slow euthanasia death. The LCP should have a public debate and not cloaked in secrecy. I only found out about this cruel practise after my brother died as I was trying to make sense of how he died. How many people know “We do not promote advanced life support” is on a Marie Curie website, you have to search for it but it is there. They do no tests so how could they tell if an LCP patient is getting better.

    1. As someone who used to ‘temp ‘ in a palliative care unit as a student, I can tell you that the staff are fully aware that morphine is given to end a life by supressing respiration. They are not allowed to admit this, as in law, deliberately administering a drug to end a life is murder..so they dress it up in euphemisms to avoid prosecution.
      Having watched someone riddled with intractible pain after a hospital misread no less than 3 smear tests as ‘clear’, I don’t mind them doing this IF THE PATIENT CONSENTS. My niece was a nurse herself – 32 years old, and by the time they discovered her cancer with a correct smear, she had secondaries in all major organs – kidneys liver lungs pancreas ..just covered in it. She called time on herself at the Mac Unit after developing gangrene in both legs, knew exactly what they were doing and blessed them for it.
      HOWEVER….there is NO DOUBT WHATSOEVER that the LCP is being used to deliberately end the lives of troublesome elderly who are NOT REMOTELY TERMINALLY ILL…to save the cost of offering them treatment for conditions as treatable as COPD and renal failure….they lie to pensioners about their right to dialysis treatment to save money..they are even fiddling their ‘Dr Foster’ scores for unexpected deaths by ‘back coding ‘ pensioners as ‘palliative care only’….which makes their deaths ‘expected’…the abuse is systemic and its murder…its not a ‘mercy killing’ at all…..

  14. after reading all these letters about how cruel the liverpool care pathway is i myself am 100% sure it should be stopped immediately to save innocent lives being taken away early its more than disgusting and a cruel way to end bed blocking and get paid for it i just find it so wicked and very evil, god help us what next the gas chambers. come on david cameron its now down to you if you have any feelings for our british citizens.you must bring it to a halt now.

  15. How is this NOT ‘hastening death’? The LCP says they should take your cardiac defibrillator out (!!!) and stop what they term ‘unnecessary medications’ (like inhalers if you have COPD!!!) – we know hospices give morphine to deliberately kill people with incurable cancer -they have done for years – and no one has minded,because there was no cure, and sometimes the cancers were very very painful. So there was a sort of ‘wilful blindness’ as to what the morphine actually did , and we let nurses and doctors get on with it. Now unfortunately, we have a breed of ‘corporate nurses ‘ and ‘business doctors’ – it only takes one generation to breed them -they have had to pay for their training, so they dont really believe in the NHS in the same way the post war generation did.They are using the hospice style doses of morphine for people who are NOT IN PAIN, just elderly…we saw how ‘terminally ill’ Rusty Lees mother WASN’T, and we arent idiots. I do wish Age Concern were opposed to this …I think they’ve been misled a bit by corporate doctors to support it….they should insist at least on the patient’s informed consent to be on this pathway..as it is, you are put on it behind your back!

  16. i just cannot see what medical knowledge age concern has anyway to support this crime of the century, i am not knocking you anita i think your letter was very well written superb. keep up the protest.

  17. i can go back to 1957 and this was going on then and how long before that.my baby sister was born with downs syndrome , my mother wasnt even told she was a downs baby, she was kept in hospital until she died at five weeks old, we didnt know then but she was fed just sugar water till she died. my mother refused a pst mortem, she didnt want her cut up ,as she described it.they did a post mortem without permission which a nurse friend of my mother pointed out when she lay in her coffin, then years later parts of babys bodys where found in alder hey hospital. more secrets. so all this has been going on long before this l.c.p stuff.my mother never got over what happend.

    1. Dreadfully common back then..and with the LCP, its gone full circle and disabled kiddies aren’t safe again..only the NHS dont want to waste 5 weeks of ‘care ‘ and the money it takes to keep them in a bed for that long, or even to pay for the sugar in the water, so they dress it up as ‘palliative care’ and give them overdoses of morphine and pancuronium bromide..I shudder when I recall Claire Rayner of all people talking about ‘letting them fade’ as she put it on a chat show in the 1970s…..her of all people! I temped in a macmillan unit when I was a student in the 1970s, and saw them give overdoses to about 3 people as it was coming up for a bank holiday…those drugs DO kill whatever they try to say to the papers….now we have Downs syndrome adults holding down jobs and running their own lives and having partners and a full life……its only eye shape in most cases…how on earth can they tell when theyre just born????

      1. ..besides which, its up to the patient and parents to give consent for any treatment , and not for some complete stranger in a hospital to decide what is in their ‘best interests’! Amazing how often they think its in a patients ‘best interests’ to die really quickly, isn’t it! There are some real shockers graduating from medical schools with the title ‘doctor ‘ nowadays – its a business to them..peoples wishes and feelings don’t even come into consideration…they just go ahead and do it behind the relatives’ backs anyway…death obsessed doctors…really very disturbed people, and drug addicts and boozers too,but so plausible and well spoken, the police believe them if you tried to complain…..

  18. i just cannot believe how age concern can condone this evil procedure if you can read the articles in the national papers were not put in by journalist, it was four top professors and twelve top nurses who gave them permission to print how bad this starvation dehydration and put into a morphined induced coma, why would professionals tell lies, in the freedom of information act they get paid to put patients on this evil regime, are you getting a cut to tell lies never a true word spoken in jest.

    1. They are now doing ‘BOGOF’ offers with the LCP at one Hampshire GP surgery! Perhaps all WW2 veterans in the area would like to avoid the practice in question in Swan Lane , Petersfield? To have a veteran and his refugee wife started on the death pathway drugs without even visiting them to see if the morphine was clinically warranted, or even consulting their son !!! If you feel this is a suspicous death, report it to the local Coroner

  19. I agree , Age Concern should be withdrawing their support from this ‘End of Life Care Pathway’…one mistake is one too many, and they clearly don’t care whether anyone consents to it or not!
    Perhaps AC should consider this at the next Board Meeting? They are supposed to support the Elderly, first and foremost. Most elderly citizens want to be kept alive, and treated with respect, not automatically disposed of.
    Or maybe we should vote with our feet and stop purchasing their Insurance Policies and other products?


      You are clearly reliant on the MC institute for the statements you are making here..it DOES hasten death..ie it kills. It is irresponsible for you to just print what they are issuing to get their necks out of the sling without understanding what ‘hospice care’ is designed to do, and what morphine is designed to do…..20 mg caused the irreversible coma in a 48 year old with asthma Mrs Renate Overton in the Howard Shipman case…she survived 14 months so he was never charged with her murder (year and a day)..but the LCP allows ‘prn’ doses ie no upper daily dose limit , all left up to the GP and care home owner ! No inquest either. Clearly it kills. It was designed to kill…..

  20. from what i have rea an duly considered,it seems that that Age Concern has become yet anothe retailer and although I hesitate to think this thought Marie Curie ..when noble charity becomes obsessed with sales and so on and needing volunteers to bring in the money then ,well,too distressing for words.

  21. i couldnt resist another comment about this l.c.p. business, i dont know whether people do know this has been going on for many, many years but nobody talked about things like they do now. i do remember when i was a child in liverpool the joke was, if your getting on a bit and you go into hospital be carefull if they moved you to the end bed in the ward cos then you knew that was your lot. i bet maggie thatcher wont be put on the so called pathway. she is far too important, god help her shes going senile so her family have dumped her in some posh hotel.

  22. hi dora, what you have printed is a credit to you in my eyes you speak with wisdom these are the whitewashes for the killing regime, paliative care, mcmillan nurses, they will get you a priest or whatever religion is available at the hostpital, more like c of e they also help you with funeral arrangements , oh and free car parking, dont forget all this is paid for with the vast amount of money they get from cquin they get paid for putting patients on the liverpool suicide uncaring pathway to hell, i am only too glad all these professors and learned doctors are whistleblowing this alone proves it should be abolished, and will be unless this country wants a revolution there are too many being slaughtered like cattle.

  23. to age concern, can you not see what this liverpool suppose to be care pathway are doing to old peop0le of our country, and its not just the old, and not just the terminally ill they are doing it widespread because they are being bribbed to kill patients , for you to support this back door killing is it that you get a cut from it for keeping a blind eye, it has now got that low it is used on new born babies , they have started to use this starvation dehydration and put into a coma with powerfull drugs and srynge driven on babies as well, if this is not MURDER, I have a pea for a brain. who are age concern suppose to help i wonder.

  24. Thank you all for your comments. We recognise at Age UK that this is a deeply emotive issue and one that has stirred up a lot of anger and sadness.

    We continue to stand by the statement that “where the LCP is properly implemented, it provides some of the highest standards of end of life care”.

    However, we fully recognise concerns that “a number of people have reported inappropriate use of the LCP, or care that does not live up the standards it describes”. When the government review is published in the summer, we will have a more complete picture about where things have gone wrong.

    Clearly, any and all concerns must be taken very seriously and we will certainly be including your views, and any other feedback from older people, in our on-going work on this issue.

    The crucial point is that there are deep problems with how health services care for older people and through all of our work, including the Dignity In Care Commission, this is something we are trying to tackle head on.

    Following the publication of the Francis Report, in response to the failings at the Mid-Staffordshire NHS Foundation Trust, we will be working hard to spur the Government into implementing wholesale changes.

    We have now closed comments on this particular post.

    Many thanks

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