The recent report on the Liverpool care of the dying pathway, (LCP) 'More Care: less pathway...' by a group chaired by Baroness Julia Neuberger has led to much soul searching particularly amongst those who had time to learn how to use the LCP correctly.
Proper use of the LCP tool (its just one tool - not a whole toolkit) left people at the end of life (who are be believed to be within approximately 72 hours of dying, as far as professional judgement can be accurate) freed from unnecessary treatments and interventions; it enabled all those involved to have an understanding of what was happening, with a mutually agreed approach towards letting the death happen whilst keeping comfort, dignity and respect for the dying person at the forefront of the care that needed to be delivered.
The report speaks of evidence of good practice yet it reaches the conclusion that the LCP should be left behind as, in the name of the LCP, much poor care of the dying had taken place. I believe it likely that the poor care would have taken place anyway as there would have to be a culture of accepting poor care, to allow misuse of a tool such as the LCP.
Healthcare professionals do need to be careful about terms such as care pathway; it is all too easy to take a professional short cut when faced with pressures of work. In the last week research undertaken by Dr Kristian Pollock highlights the effects busy-ness for care staff has on their ability to interact with the dying person on hospital wards.
So this got me thinking about pathways; whilst taking a train journey a few days ago I listed pathways I could think of:
- Stepping stones
- Wooden deck