Relatives get right to be informed of ‘pathway to death’ decision

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MEDICS will be forced to inform families when an ill relative has been placed on a so-called “death pathway” under changes to the NHS constitution to be announced today by Health Secretary Jeremy Hunt.

The Liverpool Care Pathway (LCP), which involves withdrawing food and water from patients in their final hours, has drawn sharp criticism after it emerged some hospitals had not informed relatives of its use.

Mr Hunt is expected to say families will have a legal right to be told that doctors are using the pathway, although it was not clear last night whether medics could face formal legal action if they do not comply with the ruling.

The Liverpool Care Pathway has been supported by more than 20 major medical associations and Royal Colleges, with representatives signing a statement of consensus on its use in September.

That statement says the LCP “is not in any way about ending life, but rather about supporting delivery of excellent end of life care”.

The Royal College of General Practitioners has been particularly outspoken in its anger at those who have presented the pathway as a “death list” and last night repeated its support for “planned end of life care”.

Dr Clare Gerada, the chairman of the RCGP’s Council said: “Far from being ‘sinister’ or being placed on a ‘death list’ it is important to talk sensitively to patients who are coming towards the end of their life about their wishes, such as whether they want to be cared for in their own home rather than in hospital.”

Speaking ahead of today’s announcement Mr Hunt said: “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.”

Other measures in the proposed changes to the NHS constitution include a new right for patients to receive acknowledgement, explanation and apology where mistakes have been made.

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

Under the measures being put out for consultation, health trusts that fail to discuss issues properly could be sued. Doctors who ignore the wishes of patients and relatives face being struck off.

For the first time, the coalition’s policy on single sex wards would be included in the constitution. The document would pledge those admitted to hospital “will not have to share sleeping accommodation with patients of the opposite sex”.

Other planned changes include 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, and a warning that abusive and violent patients could be denied access to NHS services, if it is “safe” to do so.

Health Minister Norman Lamb said: “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.”

Marie Curie Cancer Care welcomed the proposed new legal right for patients to be consulted on end-of-life care decisions.

But the charity said the Government should go further and called for the next independent national audit of the Liverpool Care Pathway to be brought forward.

Imelda Redmond, director of policy and public affairs, said: ““We have become increasingly concerned about the damaging media coverage... That is why we are calling for the next independent national audit to be brought forward so that we can identify as soon at possible where these failings are taking place.”