Dying patients must be given better end-of-life care, says Nice

  • Health

Dying people should be given better end-of-life care with more focus on their individual needs, under new guidelines issued by Nice.

Doctors and nurses must move away from the "tick-box" culture which existed in many hospitals and not make "snap" decisions about patient care, the health watchdog said.

ITV News reporter Martha Fairlie reports:

The dying person's wishes should also be taken into account - such as if they have asked for a do not resuscitate order - alongside their preferred place of death and spiritual needs.

The new guidance was issued following heavy criticism of the Liverpool Care Pathway (LCP), the system which was in place for a palliative care.

Hospitals were paid millions to reach targets for the numbers of patients dying on the LCP.

It was phased out last year after it emerged some patients were left without food or water, or were so heavily sedated they could not be roused.

In some cases, families were never told their loved ones had even been put on the controversial pathway.

Doctors and nurses are urged to move away from a 'tick-box- culture approach to end-of-life care. Credit: PA

The new Nice guidelines state doctors must:

  • Encourage patients to drink if they are able to do so, or swab their mouths with damp sponges or oral sprays if not to relieve discomfort

  • Consider giving fluids via a drip to dying patients to relieve symptoms such as a severe dry mouth or delirium

  • Look out for signs the patient may be recovering, even temporarily, or stabilising

  • Look to relieve other symptoms experienced by those close to death such as agitation, hallucinations, nausea and vomiting, fluid on the lungs and pain

  • Patients should be reviewed daily and medical investigations that are not needed or not beneficial should be stopped

Sam Ahmedzai, chair of the committee which developed the guidelines, said: "The LCP was originally developed to help the NHS provide 'a good death' for people at the end of their lives.

"However, its implementation became increasingly controversial over the years with stories of fluids and medicines being withheld, over-sedating the dying person.

"There were also problems with inexperienced staff recognising when someone was truly close to death, or if they had a possibility of recovery - it became seen as a 'tick-box exercise' and a 'one-size-fits-all' approach."

Claire Henry, Chief Executive of the National Council for Palliative Care, said end-of-life care in the UK was "world class" but there were still too many people dying without dignity.

She added: "The new Nice guidelines are so important and so welcome.

"However, they must also be accompanied by end-of-life training, greater support for healthcare professionals and an unwavering commitment to transforming care of the dying.

"That is how we can ensure that the care every dying person gets in their last days is as personal and high-quality as we would want for ourselves and our own families."