New end-of-life care legal rights

Relatives are to get a legal right to be consulted before food or water is withdrawn from terminally-ill patients under the so-called "pathway to death," under new Government proposals.

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Why has the care pathway been controversial?

According to newspaper reports, several families have complained about use of the care pathway.

The Liverpool Care Pathway has come under criticism Credit: PA Archive

Some relatives have claimed that their loved ones were put on the pathway without their consent and some have said it has hastened death in relatives who were not dying imminently.

Critics say that it is impossible for doctors to predict when death is imminent, so the decision to put a patient on the pathway is at worst self-fulfilling.

The media has also reported that use of the pathway is being encouraged for financial reasons, linked to targets.

The Daily Telegraph reports that almost two-thirds of NHS trusts using the LCP have received “payouts” totalling millions of pounds for hitting targets related to its use.

While these financial incentives do exist, they are designed to support the implementation of better care, say the NHS.

Health Minister: 'Everyone has the right to first class care'

The NHS is one of this country's greatest achievements. This Government will always make sure it is free to all, no matter your age or the size of your bank balance.

That's why at the same time as we are protecting its budget, we are strengthening this constitution, which enshrines the right of everyone to have first class care, now and in the future.

– Health Minister Norman Lamb

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Patients to be given new rights under reforms

  • A new right for patients to receive acknowledgement, an explanation and apology where mistakes have been made.
  • A commitment that complaints will be acknowledged within three working days, and tougher rules on handling them.
  • A warning that abusive and violent patients could be denied access to NHS services, if it is "safe" to do so.

What is the Liverpool Care Pathway?

The Liverpool Care Pathway (LCP) is a scheme that is intended to improve the quality of care in the final hours or days of a patient’s life, and to ensure a peaceful and comfortable death.

It aims to guide doctors, nurses and other health workers looking after someone who is dying on issues such as the appropriate time to remove tubes providing food and fluid, or when to stop medication.

However, its use for some has become controversial, with relatives reportedly claiming it has been used without consent, and some saying it is used inappropriately.

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New NHS constitution rules proposed

New commitments on end-of-life care and single-sex wards are set to be included in the NHS constitution, under proposals unveiled today.

Doctors will need to discuss issues with patients properly Credit: PA

Ministers said the wide-ranging package of reforms would empower patients and ensure their wishes come first.

Rules on involving individuals and families in treatment decisions are being strengthened following an outcry over secretive use of the Liverpool Care Pathway - which involves withdrawal of fluids and food.

Doctors withholding end-of-life care decisions would be struck off

Health trusts that fail to involve patients and families in decisions on end-of-life care could be sued, while doctors who ignore their wishes face being struck off as part of NHS reforms.

A Department of Health source said: "NHS bodies, as well as private and voluntary providers supplying NHS services, are required by law to take account of it in their decisions and actions.

"End-of-life care, like the Liverpool Care Pathway, can give patients dignity and respect in their last days, but recent reports have suggested that there is more the NHS can do to ensure that patients, their family and carers are fully involved in all discussions and decisions."

Hunt: Reforms will improve 'basic rights' for vulnerable

Health Secretary Jeremy Hunt told the Daily Mail that the NHS 'Death Pathways' reforms would ensure patients' and families' "basic rights" are fulfilled:

I want our country to be the best in Europe to grow old.

End-of-life care decisions affect older, and more vulnerable, people. These patients and their families have a basic right to be involved in discussions and decisions affecting their end-of-life care.

This new consultation will help to raise awareness of these rights and ensure that there are tough consequences in any cases where standards fall short.

– Jeremy Hunt

Families to be consulted on end-of-life care

Families are to get a legal right to be consulted before patients are put on the "death pathway", Health Secretary Jeremy Hunt will announce this week.

The new obligation on doctors will be launched on Monday as part of a raft of changes to the NHS constitution.

The move follows the emergence of cases where patients were placed on the Liverpool Care Pathway - which involves withdrawal of fluids and food - without relatives' knowledge.

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