NICE propose new guidance for end of life care

The proposed guidelines follow the abolition of the Liverpool Care Pathway, which was criticised as a ‘tick box exercise’ and resulted in vulnerable patients being left thirsty in their final hours.

New recommendations suggest that terminal patients should be encouraged to drink if they are able to, and receive assisted hydration where appropriate. The guidance also encourages staff to involve patients and relatives in judgements about care in a patients final days, and suggests a number of health experts should be involved rather than relying on the medical opinion of one doctor.

The chief executive of NICE, Sir Andrew Dillon, said: “Recognising when we are close to death and helping us to remain comfortable is difficult for everyone involved.

“The Liverpool Care Pathway was originally devised to help doctors and nurses provide quality end-of-life care. While it helped many to pass away with dignity, it became clear over time that it wasn’t always used in the way it was intended.

“Some families, for example, felt that elderly relatives were placed on to the pathway without their knowledge or consent. Following a review, the pathway is no longer used.

“Earlier this year, the parliamentary and health service ombudsman said that end-of-life care could be improved for up to 335,000 people every year in England. The guidelines we are developing will ensure that people who are nearing the end of their lives are treated with respect and receive excellent care.”

Roger Goss, from Patient Concern, said: "This is about the most sensible advice that NICE has put out for a long time. It is shocking that this has to be spelled out to doctors and nurses, but its not surprising in the wake of what we saw with the Liverpool Care Pathway."

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