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ARM calls for Liverpool Care Pathway to be included in medical school curriculums

Doctors have called for the controversial Liverpool Care Pathway to be put on the medical curriculum after overwhelmingly backing the end-of-life protocol.

Delegates at the BMA’s Annual Representatives Meeting in Edinburgh ‘affirmed the value’ supported the appropriate use of the pathway, but said there needed to be better implementation and training of health professionals in use of such protocols.

Experts said that much of the negative media coverage of the pathway had given the wrong impression about the possibilities of patients getting better.

Putting the motion, Dr Mark Pickering, a GP in Harrogate, said better training, quality, communications and accountability were essential to make the pathway a success.

He said: ‘It is essential that junior doctors know how to use the Liverpool Care Pathway well.’ He said he was not talking about ‘putting more on a packed medical curriculum’, but strengthening palliative care teaching to include this.

Some speakers asked delegates to defer any decision to support continued use of the Liverpool Care Pathway specifically, until the full conclusions of an ongoing Government review are released this summer.

Baroness Llora Finlay of Llandaff, professor of palliative care medicine at Cardiff University, said it would be unwise to preempt what the report will say.

Professor Finlay said much of the negative media coverage of the Liverpool Care Pathway had adversely affected people’s understanding of the care involved and that it is often viewed as a ‘one-way ticket’, when in practice many patients on the pathway  do get better with appropriate care.

She also noted that in Wales different terms have been adopted instead of ‘pathway’ to move away from the notion of a single, standardised approach for all patients.

However, Dr Tony Calland, chair of the BMA medical ethics committee and a former GP, said that doctors should give the motion their full backing to demonstrate their support for the Liverpool Care Pathway and other end of life care protocols designed to give a good death, and that ‘doctors know what they’re talking about’.

He said it gave ‘a strong message that doctors want to deal with end of life properly and that all medical professionals need to be trained properly’ in end-of-life care.

Motion in full

Motion to be proposed by the Harrogate Division:

That this Meeting:

i. notes that recent adverse media coverage has caused some patients and relatives to lose confidence in the Liverpool Care Pathway (LCP);

ii. affirms the value of the Liverpool Care Pathway in delivering excellent end of life care for dying patients;

iii. believes that strategies to implement the LCP must reward quality of care and not the frequency of use;

iv. supports the appropriate use of the Liverpool Care Pathway and palliative care in the UK;

v. asks the BMA to request that teaching in using end of life care pathway to be part of medical school curriculum.