An assurance that individual patients, their relatives or carer are consulted before anyone is placed on the Liverpool Care Pathway has been given by the Swindon-based Great Western Hospital, which covers and caters for the Marlborough area.
Concern has been expressed in national newspaper reports that patients and their families are in some cases not told that the LCP protocol has been instituted.
The Great Western had earlier reported that “up to 1,000” patients had been placed on LCP since it was introduced locally in 2010 and that no separate instances had been recorded of specific complaints from families claiming they had not been informed in advance of the procedure.
Answering questions raised by Marlborough News Online, Julie Marshman, the senior matron for diagnostics and outpatients, has issued a statement setting out the position at Great Western Hospital.
“Communication is crucial to all aspects of care and can make the difference between a good and a bad experience for patients,” she said.
“As part of the Liverpool Care Pathway process, we aim for close communication with the individual patient and their relative or carer. Prior to being placed on the LCP, the guidance we follow includes a discussion with the patient where their condition allows this to explain the plan of care. There is also discussion with the family. We recognise this is a very difficult time for many people and the Liverpool Care Pathway process includes the provision of written information.”
She added: “It is worth emphasising that life saving treatment is not withdrawn. The pathway is only appropriate if the patient has been diagnosed as dying. This involves a multi–disciplinary assessment and senior clinical expertise.”
“There will be occasions when someone who is thought to be dying lives longer than expected and vice versa. In these circumstances, a clinical review takes place as the needs of the patient may have changed.”
“The key to all of this is good communication to support patients in a dignified way at the end of life and, working with the Prospect Hospice, this is something we take seriously and aim to improve all the time.”
Concerns too have been expressed on the number of beds hospitals have available and Great Western has revealed that it is now working on a “more efficient and flexible way” of meeting demand in winter.
A spokesman told Marlborough News Online: “The GWH, like the rest of the NHS, is managing increased demand for services at a time when finances are getting tighter. The NHS as a whole is moving to providing more care in the local community.”
“Over time, this shift will see fewer beds needed in large acute hospitals like the GWH with care being provided closer to home. The important thing for any hospital is to be able to manage the increase in demand so that during winter months for example, we have the capacity to be able to open additional beds should they be required.”
The spokesman pointed out: “Working in a more flexible and efficient way means we free up resources for other aspects of patient care.”
On the issue of failings in care by nursing staff expressed in a national survey report, the spokesman added: “Every year there are around 1.5 million patient contacts within our Trust and independent patient surveys tell us that the vast majority of patients we see and treat rate their care highly.”
“We consider patient safety and quality to be our top priorities and we are always looking at ways we can improve the standard of care.”
And he added: “Later this month we will be launching a new nursing strategy for the Trust designed to strengthen the role of nurses on the ward to help maintain and improve high standards for all of our patients.”
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