Liverpool pathway binned.

[Allen]

Having been on the receiving end, so to speak.....I have nothing but praise for the palliative care team at the Northern Genereal.

When my wife was slowing dying from cancer, she made the decision herself not to have any more blood transfusions. They were the only thing keeping her alive.

The treatment was painfull and distressing.

No doctors were involved in the decision...it was hers alone.

 

It was then that her care was transferred from Weston Park to the Northern.

She and the family were fully informed every step of the way.

The care and attention she received was second to none.

The family were given "open visiting hours" and had those precious days to say our goodbyes.

 

I've also read the article by the way.....and other than saying it should be replaced....they haven't suggested an alternative?

[pattricia]

Having been on the receiving end, so to speak.....I have nothing but praise for the palliative care team at the Northern Genereal.

When my wife was slowing dying from cancer, she made the decision herself not to have any more blood transfusions. They were the only thing keeping her alive.

The treatment was painfull and distressing.

No doctors were involved in the decision...it was hers alone.

 

It was then that her care was transferred from Weston Park to the Northern.

She and the family were fully informed every step of the way.

The care and attention she received was second to none.

The family were given "open visiting hours" and had those precious days to say our goodbyes.

 

I've also read the article by the way.....and other than saying it should be replaced....they haven't suggested an alternative?

 

I was a nurse and have read your post carefully. I agree with everything you say.

[fairyworld14]

Have just messaged my friends & the LCP is going to be discontinued but there is a new one under a different name coming up

[janie48]

Its such a shame the LCP has failed is some way, it was set up with the very best intentions, supposedly modelled on the Hospice care system.

A person approaching death with no chance of recovery deserves to be allowed to slip away with dignity without using measures that prolong their suffering. That should always be ensuring the highest standards of comfort and monitoring pain control.

 

I would really need to hear more about why the system failed before forming an opinion.

[Rupert_Baehr]

I doubt that anybody is going to start accusing healthcre workers of (in some unspecified way) ' abusing' the system.

 

If there is a shortfall, then (IMO) It's more probably due to the classic 'let's put our heads in the sand and wait until the problem goes away' attitude adopted by successive governments and those responsible for administering the funding of the NHS.

 

We've all heard (on a number of separate occasions during th past weeks and months) that the NHS is facing a 'funding crisis', that unless 'something' is done, the NHS will be unable to fund certain procedures. that... (the list goes on.)

 

Demands on the NHS are increasing.

The cost of providing an increasing range of services is increasing rapidly

Funding is not keeping pace.

 

If the NHS 'can't afford to fund certain procedures' that means patients have to do without those procedures.

 

Ideally, it's up to the people (guided by [hopefully] impartial and well-informed medical advice) to decide what the NHS is going to fund and how it is going to provide that funding. Yet a few weeks ago, when a group of doctors were suggesting doing precisely that, there was an outcry on this forum!

 

Unfortunately, you can't get away with saying: "Let the rich pay for everything".

 

1. They haven't got enough money to pay for everything and

2. They will simply refuse.

 

I suppose you could stick a very hefty tax on the profits of every company.

 

That would provide lots of money... Until companies found that they were having to increase the charges for the goods and services they provided to such a level that the Brits bought those goods and services elsewhere and the companies folded.

 

There is no simple answer. The NHS needs more money, the NHS may need to review how it spends the money it's got.

 

Perhas there hould be a list of medical treatments which are available on the NHS and a list of those that are not.

 

If a treatment is on the list of 'available treatments' should the NHS be allowed to deny that teatment to a patient?

 

(My private Insurance scheme doesn't cover everything [amongst other exclusions, it refuses to cover 'experimental and other treatments of non-proven benefit.']

 

If a treatment is covered, however, it can't turn around to me and say: "We've spent enough money on you - we're not spending anymore."

 

Should that rule apply to the NHS?

 

(It's already been suggested on this forum that certain people should be denied treatment on the NHS because of their age or because of other factors.)

 

Should all 'cosmetic' or 'non-life threatening' procedures be funded by the patients themselves?

 

Those are all decisions which will have to be made at some time.

[tinfoilhat]

I doubt that anybody is going to start accusing healthcre workers of (in some unspecified way) ' abusing' the system.

 

If there is a shortfall, then (IMO) It's more probably due to the classic 'let's put our heads in the sand and wait until the problem goes away' attitude adopted by successive governments and those responsible for administering the funding of the NHS.

 

We've all heard (on a number of separate occasions during th past weeks and months) that the NHS is facing a 'funding crisis', that unless 'something' is done, the NHS will be unable to fund certain procedures. that... (the list goes on.)

 

Demands on the NHS are increasing.

The cost of providing an increasing range of services is increasing rapidly

Funding is not keeping pace.

 

If the NHS 'can't afford to fund certain procedures' that means patients have to do without those procedures.

 

Ideally, it's up to the people (guided by [hopefully] impartial and well-informed medical advice) to decide what the NHS is going to fund and how it is going to provide that funding. Yet a few weeks ago, when a group of doctors were suggesting doing precisely that, there was an outcry on this forum!

 

Unfortunately, you can't get away with saying: "Let the rich pay for everything".

 

1. They haven't got enough money to pay for everything and

2. They will simply refuse.

 

I suppose you could stick a very hefty tax on the profits of every company.

 

That would provide lots of money... Until companies found that they were having to increase the charges for the goods and services they provided to such a level that the Brits bought those goods and services elsewhere and the companies folded.

 

There is no simple answer. The NHS needs more money, the NHS may need to review how it spends the money it's got.

 

Perhas there hould be a list of medical treatments which are available on the NHS and a list of those that are not.

 

If a treatment is on the list of 'available treatments' should the NHS be allowed to deny that teatment to a patient?

 

(My private Insurance scheme doesn't cover everything [amongst other exclusions, it refuses to cover 'experimental and other treatments of non-proven benefit.']

 

If a treatment is covered, however, it can't turn around to me and say: "We've spent enough money on you - we're not spending anymore."

 

Should that rule apply to the NHS?

 

(It's already been suggested on this forum that certain people should be denied treatment on the NHS because of their age or because of other factors.)

 

Should all 'cosmetic' or 'non-life threatening' procedures be funded by the patients themselves?

 

Those are all decisions which will have to be made at some time.

 

Interesting. I watched sicko, a film that Michael Moore made. Now he's just about the ultimate one eyed lefty but he seemed to talking to real people who couldn't get insurance and/or treatment. Was that all rubbish and devoid of fact or are there at least variations from state to state etc? If you haven't watched it, give it a go (although avoid the end 20 minutes or so;))

 

There are certain drugs that the Nhs won't prescribe after direction from the national institute of clinical excellence (nice) because drugs don't give "value for money". Lcp isn't that, it's more a case of speeding up someone's death and the reasons why. When used correctly its good idea but the web is littered with stories when it isn't.

[Rupert_Baehr]

Perhaps Michael Moore (Hardly renowned for making unbiased films) made his film before Obama passed his law?

 

'Prohibition' has been repealed in the US, too.

 

There are indeed many people in the US who can't get medical insurance and treatment.

 

If, for instance, you were living in Harding County New Mexico (I'll use that county as an example because I know it) and you wanted to see an Ob-Gyn doctor, you might have a few problems finding one. Harding county (about half the size of Yorkshire) has a population of 591 people. Not many of them are doctors - of any specialism. If a doctor has to make a living from the fees paid by the patients and there aren't enough patients, then either no doctor will take on the job or those that do will starve.

 

With effect from next Year, that nice Mr Obama has introduced compulsory insurance for everybody - so there will be no uninsured people in the US. I've no doubt whatsoever he will explain (any minute now) where all the doctors are going to come from. (If you see US medical recruiters in a town near you, that might give you a clue. )

 

NICE probably does a very good job and I've no doubt that the people tasked with making the decisions do so very carefully indeed

 

Not all of the occasions on which treatment is declined are predicated by the perceived 'quality' of a drug. On some occasions, the treatment itself is expensive and the NHS - or perhaps just that part of the NHS - may not have the money. The 'Postcode lottery' appears to be alive and well.

 

(I wonder what happens if an NHS patient (with medical travel insurance and a Euro medical card) gets sick somewhere else in Europe? Is that patient told: "Well, your own people aren't prepared to do any more for you so we're not either" or is he told: "Get into this hospital. Let's have a look and see what we can do"?)

 

As far as the LCP goes, perhaps it needs to be re-branded' and re-sold' in the UK?

 

Americans are hardly renowned for sitting back and accepting what doctors say, but 'Living Wills' or 'Advance Directives' or whatever else they're known as in the US are becoming increasingly popular - almost the norm. I've no doubt that some people were concerned that a 'Living Will' would be used as an excuse to switch off life support - but that hasn't happened. The controls are very strict and many people welcome the opportunity to have the option of a more dignified(?) (Certainly less protracted) death.

 

The person making the 'Living Will' has to be of Sound Mind and can specify a large range of eventualities under which the terms would be invoked and conditions which must be met. It might be difficult to sell the concept in the UK - but I doubt it would be impossible. - Provided you could persuade people it wasn't being done merely to save the NHS a bit of money.

[Canx]

The Government is to replace the Liverpool Care Pathway (LCP) and will ask senior clinicians to sign off all end of life care plans, as part of its response to the findings of an Independent Review:

 

https://www.gov.uk/government/news/overhaul-of-end-of-life-care-system

[Anna B]

What are they going to replace it with?

 

I've read the link, but it doesn't really say anything.

[SevenRivers]

FYI there was a thread started a couple of days back:

 

http://www.sheffieldforum.co.uk/showthread.php?t=1196998&highlight=liverpool