The Liverpool Care Pathway for the dying patient (LCP) is an outline of care which a patient can expect in the final hours and days of life, which also becomes a structured record of the actions and outcomes that develop.

It aims to guide members of the multi-disciplinary team in matters relating to continuing medical treatment, discontinuation of treatment and comfort measures during the last days and hours. Its main emphasis is uniting professional support in the fields of physical treatment, psychological support, support for carers and spiritual care. The Liverpool Care Pathway is organised into sections ensuring that evaluation and care is continuous and consistent. Professionals using the Pathway need to ensure that both patient and carers understand that the structure and focus of care has now changed and the focus is now on care and comfort during the end stages of life.

The pathway was developed to act as a guide only. It was never intended to replace the skill and expertise of a health professional. It provides the practitioner with specific prompts to act upon, and aims to alleviate symptoms and to keep patient comfort at an optimum level. Its lack of complexity, and ease of use makes the structure amenable to all health disciplines.

The Liverpool care pathway was developed between the Royal Liverpool hospital and the city's Marie Curie hospice in the late 1990s to transfer best practice in the dying phase from hospice to hospital. The document has an annual review by the multidisciplinary steering group who review the latest evidence and feedback from uses of the pathway to ensure that it remains up to date and current.

According to the National Mortality Statistics 2004, only 16% of cancer deaths and under 5% of non cancer deaths occur in a hospice.^[1] Bearing this in mind, therefore, it is essential that a person experiences the same level of nursing expertise at the end of life regardless of their chosen environment.

The pathway has been blamed by some doctors for hastening the death of some mortally ill patients.^[2]

[edit] References

• Ellershaw J (2007) Care of the dying: what a difference an LCP makes. Palliative Medicine 21:365-368

[edit] External links

• Liverpool Care Pathway for the Dying Patient (LCP), Marie Curie Palliative Care Institute, Liverpool.
• Your Guide to the Liverpool Care Pathway for the Dying Patient, Marie Curie Cancer Care, January 2009
• LCP information leaflet for relatives and carers
• LCP standard template, for use in a hospital, Version 11 - November 2005
• What is the Liverpool Care Pathway?, Cancer Help UK, Updated 5 December 2008
• Amanda Taylor, Improving practice with the Liverpool Care Pathway, Nursing Times, 30 August 2005
• Ensuring people die with dignity, Nursing Times, 9 December 2008

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