THE architects of the Liverpool Care Pathway (LCP) have defended the controversial model of care that has faced an onslaught of criticism in recent weeks.

One national newspaper has even branded the end of life plan now adopted throughout the UK as being a “pathway to death”.

Worryingly, critics of the LCP said that hospitals are even being given financial rewards worth millions of pounds to put patients on the regime.

Senior cancer doctor Prof Mark Glaser, accused NHS managers of using the pathway to clear beds and achieve targets.

But the people behind the care plan hit back.

Prof John Ellershaw, director of the Marie Curie palliative care institute in Liverpool and Deborah Murphy, associate director, said: “The sole purpose of the LCP is to provide the best possible care for people in the last days or hours of their life.

“That was the purpose when we at the Marie Curie and our partners in Liverpool set out in the 1990s to design a framework for health professionals to use to ensure that people who are dying have as comfortable and dignified a death as possible, and it remains the purpose today.

“It was a response to the poor care and suffering of dying patients in hospitals in this country, and we had a simple aim: to bring best care of the dying – of the type that people experienced in hospices – to the wards of general hospitals.

“Since the 1990s, the LCP has been developed, supported by evidence and research of the highest quality. Remaining central to the LCP, however, are good care, compassion and communication.”

It has been reported the LCP involves the withdrawal of life-saving treatment with patients sedated and the majority denied nutrition and fluids by tube. But the experts say that the LCP is not a ‘one size fits all’ prescription but tailored to each patient.

And medics say the LCP – a document that helps them manage end of life care – does not recommend continuous deep sedation but a review of medications and open discussions with relatives. If possible, patients may stop unnecessary treatments and interventions, shifting the focus of care to comfort and dignity.

Supporters strongly refute the LCP is a form of “euthanasia”.

Families fear loved ones are being put on the pathway to hasten death.

But Prof Ellershaw and Ms Murphy said: “Many, many thousands of patients and their families have benefited from improved care as a result of the LCP.

“The provision or withdrawal of interventions with the direct aim of hastening death is contrary to the rationale of the LCP, contrary to GMC (General Medical Council) guidance, and illegal.”

While Prof Ellershaw and Ms Murphy are the main architects of the LCP, responsibility for day-to-day implementation lies with individual hospitals, GPs and care homes.

Experts argue that before the LCP, there was not such a formal approach to end of life care which led to poor care in the final days of life in some instances, including unnecessary medical treatments.

While written consent is not needed before a patient is put on the plan, Prof Ellershaw and Ms Murphy added that “there should never be an occasion when the relative or carer who is named as the first contact or next of kin is unaware of the diagnosis of dying or of the subsequent care plan.”

A GROUP of senior doctors has set up a full study into the Liverpool Care Pathway.

They said they wanted to investigate public concerns over the use of the controversial Liverpool Care Pathway, which has been used without family members’ knowledge.

The technique is supposed to alleviate suffering in the final hours or days of a person’s life and can involve the removal of tubes artificially providing food and fluid.

But across the country, families have come forward saying their loved ones were placed on the pathway without their knowledge and argued they were not dying.

A group of senior doctors said the decisions that patients were dying are based on no evidence and are often little better than “guesswork”.

They said that once patients were on the pathway with food and fluids withdrawn, the prediction of imminent death became a “self-fulfilling prophecy”.

Dr Bee Wee, president of the Association for Palliative Medicine, has said rather than simply defend the pathway, it is right that experts stand back and look at the issues raised.

Dr Wee, said: “We were pleased to contribute to the discussion on the Liverpool Care Pathway (LCP) and care of those who are dying at Minister Norman Lamb’s round table discussion.

“We welcome the Minister’s announcement of an independent chair for the reviews on care in the last days of life.

“We look forward to contributing to this through our planned survey of health and social care professionals starting in early December.

“This work, in collaboration with the National End of Life Care Programme and other national bodies, will help us to understand professionals’ experience and views on Integrated Care Pathways (ICPs) for the last days of life.

“These ICPs, of which the Liverpool Care Pathway is one, provide a template for co-ordinated multi-disciplinary care and are designed to reduce variation in practice and enable the same high quality care to be provided for all.

“It is essential that people’s experiences of last days of life are properly understood, helping us to continue to make improvements to the care we provide to those who are dying and their loved ones.”

Dr Wee, a consultant and Oxford academic, added: “There are some very real anxieties amongst the public and some professionals about this whole concept.

“Instead of simply defending the concept, or reiterating that if only it were used properly, it would be OK, it might be more helpful to stand back a bit, identify and explore the concerns properly, and find ways of addressing those concerns and improve practice.”