Jacqueline Laing addresses concerns about the Liverpool Care Pathway
In 2008, a year after the Mental Capacity Act 2005 came into force, the Liverpool Care Pathway was recommended as the Department of Health’s end-of-life care strategy. Only a year later 300 hospitals, 560 care homes and 130 hospices in England had rolled out the programme. Around 130,000 people a year now are reported to die on the Pathway (29% of the annual 450,000). Freedom of Information Act requests performed by one enterprising journalist subsequently revealed financial incentives to hospitals and care homes that implemented the programme (J Bingham, “NHS millions for controversial care pathway”, The Telegraph, 1 November 2012). Millions of pounds were paid to roll out the regime. The sub-programme, Commissioning for Quality and Innovation (CQUIN), requires that local NHS commissioners remunerate trusts for meeting “Gold Standards” targets in implementing the Pathway. In certain areas, targets are set specifically to increase the numbers of people in their hospital dying on the Pathway. More worryingly, some hospitals had set targets of between a third and two thirds of all the deaths to be Pathway deaths.
