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.

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