Transcript Slide 1
The Liverpool Care Pathway Dr Kate Tredgett, Consultant in Palliative Medicine Place of Death *Data from End of Life Intelligence network * Place of death Swindon Cancer Patients (%) Swindon All Patients (%) National All patients 2008-2010 (%) Home 28 21 20 Hospice 27 8 5 Hospital 34 52 54 Care Home 10 17 18 Total 2279 Quality of End of Life Care First National Voices Survey of the Bereaved ONS / Dept. Of Health July 2012 Location of Care Number of Respondents % Rating Care Outstanding / Excellent / Good Home 3712 82 Hospital 9492 68 Care Home 4357 83 Hospice 1280 87 Research Evidence of LCP Outcomes • • • • • Improves confidence of nurses. Demonstrates reduced symptom burden. Improves multi-disciplinary team working. Improves documentation of care delivery. Improves anticipatory prescribing of medications for the 5 key symptoms that may develop. Local Support and Governance of the LCP Educational Support • Mandatory e.learning module • Biannual study days • Preceptorship training • Link nurse training • Foundation Dr training • Ward based training Clinical Governance • LCP death numbers monitored • National Biannual Audit – Dissemination of findings – Participation is a Quality Marker The LCP document • Diagnosis of dying – Audit • Decision to commence LCP endorsed by most senior clinician 96% – For 3% of patients the pathway ceases to be appropriate • Communication – A full explanation of the current plan of care (LCP) is given to the patient – Audit • 61% – A full explanation of the current plan of care (LCP) is given to the relative or carer – Audit • 94% The LCP document • Withdrawal of treatment. – Requirement is for interventions to be reviewed – Requirement if for artificial hydration and nutrition to be reviewed Local Picture LCP use Year Number of deaths supported by LCP 2010 377 2011 427 2012 (up to July) 201 – Median age 83 yrs – Median 27hrs supported by LCP Impact of recent publicity Moving Forward • • • • Information Development Continue Education and Support Participate in next National Audit Await outcome of Independent Review in summer THANK YOU