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Pathway is intended to care for dying patients, not to hasten their death

The Liverpool Care Pathway was not designed to hasten the death of patients

7:00AM GMT 07 Nov 2012

SIR – The Liverpool Care Pathway (Letters, November 3) was designed to ensure that the highest standard of care is provided for patients who are in the last few days of their lives. It is used to care for patients, not to hasten their death.

The decision to begin the care pathway is made in partnership with the patient and his or her carers. Such decisions would never be based on financial constraints, but always on recognising that a patient is dying and that further investigation and treatment would be futile, undignified and intrusive.

The pathway ensures that unnecessary medical interventions are not performed, and promotes dignity in the last hours or days of life. It highlights the importance of regular reassessment of the patient’s condition and communication with the patient’s family or carers. If a patient’s condition improves, this can be identified quickly; the care pathway can be discontinued at any time.

All of the health-care professionals who have signed this letter have been involved in the care of dying patients; many of us have also cared for friends or relatives during the final days of their lives. This is how we would wish to be cared for at the end of our lives and our patients deserve to be offered nothing less.

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Registered Pharmacy Technician
Dr Alan Woodall
Dr Fionnuala Johnston
Dr Lucy Crosland
Dr John Morris
General practice
Ms Penny Hansford
Dr James Dunbar
Dr Steven Land
Dr Stephanie Milne
Mr Simon Gosling
Medical Student
Mr Peter McKenna
Dr Deborah Stevenson
Doctor FY2
Dr Max Davie
Dr Richard Hopkins
Ms Ruth Finn Nurse
Acute care
Dr Louisa Waites
Miss Abigail Carey
Medical student – PCMD
Miss Naomi Cook
Dr Robert Varn
Dr Sarah Evans
Mrs Deborah Baw
Nurse Emergency department
Mrs Agnes Noble
Palliative care nurse cancer care
Dr Sian Beasley
Ms Jaci Joyce
Med Education
Dr George Madden
Anaesthetist Anaesthesia and Intensive Care
Dr Kai Rabenstein
Anaesthetist Hospital Medicine
Dr Marcus Baw
GP, A&E Doctor and Hospice Doctor
Dr Rajeshkumar Patel
Mrs Judith Spencer
Dr Laura Clipsham
Doctor Palliative Medicine
Mr Oliver Gosling
Trauma and orthopaedic surgery
Mrs Brenda Strachan
Dr Hannily Harvey
Ms Joanna Dunlop Macmillan
Dr Rachel Tricks
Miss Laura Chadwick
Medical Student
Dr Jennifer Mcinally
Mrs Wendy Ford
Clinical effectiveness facilitator
Dr Alec Jones
GP trainee
Dr Claudia Camden-Smith
Dr Amanda Milligan
Dr Sean Ninan
Geriatric Medicine
Ms Karin Gerber
Critical Care Nurse
Dr Rose Crane
Dr Andrew Polkinghorn
Mrs Katie Richards
Registered Nurse
Dr Kirsten Patrick
Professor Craig White
Professor & Consultant Clinical Psychologist Psychosocial Oncology
Mrs Jane Dickson
Dr Neal Navanj
Doctor Lung Cancer
Miss Laura Jane Broad
Mr Sandy Wilkie
Organisational development
Dr Katherine Sharrocks
Dr Oliver Ross-Smith
Dr Aideen Cronin
Dr William Whitehead
Miss Laura Carter
Student Nurse
Dr Katherine Adlington
Acute Admissions F2
Dr Oliver Thomas Browne
Mrs Imogen Davies
Operating Department Practitioner
Mrs Nicola Knight
Community nursing
Miss Lesley Rain
Registered nurse clinical lead
Dr Joanna Vriens
Palliative Medicine
Mrs Julie Taylor
Adult safeguarding nurse
Dr Lisa Yung
Mrs Sharon Dillon
Nurse practitioner NHS Trust
Dr Michael Warwick-Sanders
Miss Elizabeth Stapleton
Staff nurse
Dr Daniel Boaden
GP Trainee elderly care
Dr Matt Barton
Dr Alison Timmis
Dr Claire Feenan
Dr Lesley Kay
Consultant North East
Dr Eleanor Houghton
Dr E Denise Stevens
Mr Daniel Moor
Ambulance service Emergency prehospital
Dr Humphrey Scott
Dr Stephen O’Hanlon
Dr Hannah Milton
Miss Melanie Holman
Research Fellow (Surgery)
Ms Charlotte Cornwell
Student nurse
Dr J B M Doyle
Dr Adam Peckham-Cooper
DR Rob Morrison
Dr Athalia Pyzer
Dr Rikin Patel
Dr Angharad Powell
Dr Alexander Hamilton
Forensic Psychiatrist
Mrs Michelle Davies
Mr Mark Bloomfield
Orthopaedic surgeon
Dr Trefor Roscoe
Dr Julie Barnsley
Palliative Medicine
Dr Sue Robinson
Dr Jennifer Shankland
Miss Jamie Lewis
Nursing palliative care
Dr Ryan Boyle
Mr Christopher Ball
Student Nurse acute medicines
Ms Lesley Firth
Health librarian
Mrs Jayne Hopkins
Staff nurse
Ms Sue Naidoo
Consultant Nurse Critical care outreach
Mr Robbie Gittins
Therapeutic Radiography Palliative care specialist
Miss Catherine Spaven
Staff nurse ICU
Miss Jenna Hudson
Staff nurse Adult nurse
Dr Jessica Barrett
Miss Kathryn Pumphrey
Staff nurse
Ms Valeska Matziol
Community Engagement Officer Improving health and social care services
Mr Christopher Gray
Nurse Haematology
Dr Rachel Wallis
Doctor emergency medicine
Dr Matthew Devall
Doctor Consultant Paediatric Anesthetist
Ms Chloe Carter
Researcher, author of End of Life Care in Extra Care Housing for NEoLCP
Dr Suzie Gillon
Dr Rochelle Wilder
Ms Elizabeth Tweedle
Dr Nicholas Freeman
Anaesthetist Theatres and Critical Care
Miss Laura Elliott
Student Nurse
Dr Georgia Birch
Fy1 Doctor
Mrs Lindsay Mappledoram
Nurse hospital
Mr James Giles
Medical Student Medicine
Dr Russell Donald GP
Dr A D Vellore
Consultant Physician Medicine
Dr David Hogg
Mr Paul Barlow
Dr Waleed Mohammed
Miss Kelly Benning
Sister – acute care Hospital@ Night
Ms Judith Aldridge
Dr Emma Price
Dr Charles Averill
Miss Charlotte Richardson
Registered nurse gynaecology and breast
Dr Aaron Lee
Medical Student
Dr Becky Baines
Dr Kirsty Cattanach
Dr Iain Brassington
Dr Daniel Bernstein
General practitioner
Dr Z Hirst
Dr Michael Dean
Intensive care medicine.
Dr Conor Marron
Dr Christopher Brockelsby
Dr Sarah Walters
Dr Alastair Proud
Dr Anna Randall
Dr Sophie Haney
Mrs Heidi Smith
Mrs Victoria Jones
RGN HPB and UPGI surgery
Miss Jayne Birchall
Nurse Health care of the older patient
Dr Tim Roberts
Dr Victoria Burnham
Accident and Emergency
Dr Anna Down
Dr Gosia Raczek
Dr Christopher Williams
Hospital Doctor Haematology
Mrs Claire Balmer
Nurse healthcare research
Dr Alaine Cunningham
Dr Tom Connell
Ms Joyce Keast
Dr Louise Brockbank
Dr Geraldine Vaughan
Dr Amy Lawrence
Mr Nick King
Operating Department Practitioner
Miss Averil Adams
Staff Nurse
Miss Carly Le Marechal
Dr Catherine Pringle
Mr Dermot O’Riordan
Consultant surgeon & medical director
Mrs Rachel Mason
Nurse Critical Care
Dr Emily Robinson
Dr Eilidh McGinnigle
Dr Andrew Whelan
Dr Marko Nikolic
Dr Tom Yates
Junior doctor, trainee epidemiologist
Mr Damian Haywood
Senior Public Health Researcher
Dr Damian Roland
Paediatric Emergency Care and Medical Education
Miss Charlotte Develin
Registered Nurse Adult Intensive Care
Dr Tristan Lane
Dr Paul Moore
Dr Joyce Yeung
Mrs Ann Banks
Nurse Emergency Department
Dr John Mottram
Ms Sally Wherry
Ms Rebecca Statham
Admin Local Government
Dr Teresa McDonnell
Mr David Puddy
Dr Simon Bailey
Dr Sian Hartry Doctor
General practice
Dr Ushma Gadhvi
General practice
Mrs Michele Nevitt
Dental therapist Paediatrics
Dr Mhairi Hepburn
Specialist registrar in old age psychiatry
Dr David Little
Miss Marie Helebert
Patient Services Officer NHS
Dr Joanne Doran Fy1
Dr Iain Parsons
Dr Lianne Geddes
Emergency Medicine Doctor
Miss Frances Judges
Registered nurse
Dr George Reid
Dr Marianne Johnstone
Mrs Helen Lundy
Dr Norhazida Daud
Specialty Doctor Elderly Care & Rehab
Dr Ian Hunter
Consultant in Intensive Care Intensive Care
Dr Steve Cushing
Retired General Practitioner
Mr Robin Davies
Nurse Resuscitation
Mr Dermot O’Riordan
Consultant surgeon
Dr Andrew Johnson
Dr Catherine Roberts
General practice
Dr Nicholas Phelan
Ms Samantha Brace
Advanced Clinical Practitioner Emergency Medicine
Dr David Regan
Dr Kathryn Jenkins
Dr Kayleigh Mattinson
Dr Calvin Moorley
Lecturer Education
Dr Edward Costar
Mrs Joanne Merrony
Student nurse
Mrs June Roberts
Consultant nurse
Ms Susan Wellings
Ward manager (nurse)
Dr B Stahl
Mrs Emma Bennett
Nurse Critical care
Dr Lucy Bamford
Dr Atif Khan
Specialist Registrar in Geriatric Medicine
Mr Sandy Wilkie
Organisational development
Dr Rebekah Grayson Doctor
Mrs Karen Powell
Paediatric clinical nurse specialist
Dr Hugh Bishop
Consultant Paediatric Oncologist
Dr Georgios Theodoulou
Consultant Older Adult Psychiatrist
Mrs Mary Brice
Nursing Heart Failure, palliative care
Dr Olusegun Olusanya
Trainee In Anaesthesia and Intensive Care Anaesthetics/intensive care medicine
Dr Mark Dunham
Mrs Delia Stearnes
Practice Nurse General Practice
Dr Emily James
Mr Giles Thorpe
Nurse Manager
Dr Gareth Waring
Dr Sarah Massey
Dr Chloe Barter
Dr Johanna Reed
Dr Ben Ivory
Dr Carlie Gardner
Dr Paul Bhalla
Dr Mary Salama
Dr Catherine O’Sullivan
Dr Hadiza Gachi Medical
Mr Paul Young
Medical Student
Dr James Hale
Dr Isabelle Hughan
Dr Scott Grier
Anaesthetist, ST3
Mr John Laughlin
Medical Student
Dr Richard Day
Doctor ITU
Dr James Anderson
Junior Doctor
Dr Ian Nesbitt
Dr Sukhdip Jhaj
General Practitioner Primary care
Dr Sarah Spencer
Doctor Emergency Medicine
Dr Claire McBrearty
Dr Mitali Das
Dr Kunal Kulkarni
Miss Charlotte Elliker
Staff nurse Acute medicine
Dr Edward Farrell
Ms Rosie Leigh
Staff Nurse Oncology
Dr Andrew Carr
GP registrar
Dr Shawn Morais
Hospital Doctor
Dr Pete Deveson
Doctor Hugo Gemal
Dr Mark Kasozimusoke
Physician Geriatrics & General Medicine
Dr Annette Neary
Consultant Physician
Dr David Griffith
Dr Adel Hutchinson
Miss Jenna Rippon
Dr Antonia Field-Smith
Doctor Palliative Medicine
Dr Rachel Blackman
General practitioner
Miss Victoria Wilkinson-Smith
Miss Larissa Tonkin
Occupational Therapist
Dr David Wright
Dr Michael Perkin
Dr Caroline Newman
Acute medicine
Dr Sara Hamilton
Dr Kate Granger
Elderly Medicine
Miss Abi Fuller-Gardener
Miss Danielle Fletcher
Student Nurse Infectious diseases
Miss Temora Tait
NHS Ambulance service
Mrs Kimberley Fletcher
Dr Jamie Green
Dr Aaron McGowan
Mr Fawaz Arshad
Medical Student
Ms Niamh Bonner
Clinical Nurse Specialist
Ms Mairi McKinley
Nurse Lecturer
Dr Claire Dow
Consultant Geriatrician
Dr Mark Garside
Elderly Care
Dr James Hambly
Emergency medicine
Dr Eoin McCarthy
Mrs Elizabeth Naden
Staff nurse ICU
Dr Antony Lempert
Dr E Parkinson
Mrs Bernadette Rose
Registered nurse community
Miss Louise Cassy
Dr John McKenna
Mr Mark Ives
Paramedic Emergency medicine
Dr Anthony Tasker
Paediatrician NHS Tayside
Mrs Joanne Fraser
Mr Keith Strong
Medical admin
Dr Rachel Boyce
Mr Angus Carruthers
Mrs Claire Smith
Nurse community
Miss Laurie Fielding
Student Nurse
Mr Simon Taylor
Registered Nurse (Senior Matron) Acute Medicine
Mr Nicholas Francis
Medical Student
Ms Lynne Fisher
Staff Nurse Oncology
Miss Claudia Pang
Student nurse
Dr Matt Smith
Miss Nicola Parkin
Registered nurse/midwife A&E, emergency unscheduled care, maternity
Mrs Vanda Murphy
Mr Steve Hornby
Dr Adrian Wong
Dr Pamela Bowyer
Dr Suzanne Docherty
Dr Janet Sivyer
Dr David Price
Miss Racheal Dykes
Student Nurse
Dr Claire Salter
Mr Rob Bethune
Ms Sarah Ward Nurse
Critical Care
Dr Elvena Guyett
Ms Debbie Wenzel
District Nurse Community
Dr Andrew Dawes
CMT Doctor
Dr Helgi Johannsson
Dr Rachel Scott
Dr Fiona Windsor
Dr Gina Kontny
Emergency Medicine
Dr Chamali Samarasekara
Trainee oral and maxillofacial surgeon
Dr Sean Frain
Dr Jonathon Tomlinson
Dr Carol Wilson
CT3 Psychiatry
Dr Sophia Galloway
Dr Donna Fincham
Obstetrics & gynaecology
Miss Victoria Seed
Specialist nurse
Dr Ranjit Singh
Dr Joseph Anderson
Dr Rebecca Fletcher
Mrs Alyson Davenport
Advanced Nurse Practitioner Acute Care
Dr Stephen De Souza
Mrs Sarah Rose
Medical student
Miss Yasmin Draper
Student nurse
Dr John Bainton
Dr Adam Moreton
Mrs Angela Marston
Nurse Specialist palliative care
Dr Philip Anderson
Medicine Emergency Medicine
Ms Susan Saxton
Case Management/Social Services Discharge Planning
Dr Philip Williams
Dr Robyn Powell
Emergency Medicine Doctor
Dr Kenneth Atkinson
Miss Katie Smith
Registered nurse Dementia/older persons
Dr Lucy Power
Dr Way Main Wong
Dr Jayne Little Doctor
Rheumatology and general medicine
Dr Tom Cozens
Medical registrar Wales
Dr Catherine Tuson
Dr Philip Pearson
Consultant Physician
Dr Tom Smith
Intensive Care
Dr Nigel Lane
Dr Sam Thenabadu
Emergency Medicine
Mrs Donna Brain
Staff nurse
Mr Henry Fowler
Medical Student
Mr Michael Watson
NHS Manager
Mrs Paula Parr
Palliative Care Nurse Specialist Hospital
Dr Nicola Wilson Doctor
Emergency Medicine
Dr Philip Lee
Consultant Physician
Dr Neil McCulloch
Dr Daniel Freedman
Dr Alain Fennessy
Mrs Emma Gorvett
Staff nurse Community
Dr Robyn Wittersheim
Dr Iain Phillips
Dr Sue Crossland
Consultant Physician Acute Medicine
Dr Mark Wardle
Consultant Neurologist
Ms Sharon Hudson
Dr David Bramble
Dr Samuel Parker
Mrs Sarah Frank
Pharmacist NHS / Academic
Miss Amelia Russell
Orthopaedic SpR
Dr Helen Brambley
Dr Alison Crawford
Palliative Medicine
Ms Tina Fell
Nurse Cardiology
Dr Sarah Dyer
Medical registrar Respiratory medicine
Ms Tina Fell
Nurse Cardiology
Dr Varshini Singanayagam
Specialist Registrar Acute Medicine
Dr David Steele
Dr Daniel Campion
Dr Huw Williams
Mrs Pamela Mercer
Nursing assistant Intensive care
Dr Hannah Jones
Dr Carmel Tooher
Dr Robert Docking
Critical Care registrar
Dr Alexa Childs
Ms Felicity Webb
Miss Emma Wright
Dr Zoe Hodson
Dr Catherine Williams
Emergency medicine
Dr Paul Adrian Clarke
Anaesthesia and Intensive Care Medicine
Miss Rebecca Bennett
Clinical sister Cardiology SWFT
Dr Lesley Lowe
Clinical Research
Dr Paul Wyatt
Miss A Sutcliffe
Registered Nurse
Dr Chris Miles
Ms Elizabeth Midwinter
Sister Urgent care
Dr Rebecca Reynolds
Mrs Jenny Hill
Macmillan nurse
Mrs Valerie Gallagher
Mr Daniel Darbyshire
Mrs Becky Hepworth
Community children’s nurse
Dr Alexandra Ford
Dr Fiona Stonley
Anaesthetics & Intensive Care
Ms Emma Gordon
Miss Debra Hughes
Dr Sarah Ross
Miss Rosie Cadwallader
Dr Matthew Fenech
Dr Andrew Skinner
Dr Lucy Marchand
Mrs Lisa Strong
Mrs Sarah Louise Lee
Registered Nurse ADULT District Nursing
Dr Chris James
Dr Hilary Kinsler
Mrs Tina Stackhouse
Nursing assistant
Mr James van Gils
Medical Student
Dr Richard Jenkins
Dr Muditha De Silva
Miss Joanne Grew
Health Care Assistant
Dr Senem Sahin
Dr Jennifer Burns
GP registrar
Dr Felix Greaves
Mrs Rachel Telford
Mrs Laura Harper
Dr N Austin
Senior House Officer
Dr Peter Robinson
Dr Paul Morgan
Hospital Consultant Intensive Care
Dr Rosie Belcher
Medicine for the Elderly
Dr Alex Smith
Dr Emma Southall
Mrs Barbara Dilnot
Dr Nicola Davis
Dr Margaret Rose Kelly
Dr Elaine Clark
Mrs Kay Edwards
Dr Anna Morgan
Acute Medicine
Dr Keira Markey
Emergency medicine
Dr Adrian Morrison
Dr Rebecca Thomas
Registrar in Rheumatology
Ms Justine Lattimer
Barrister Child Protection and Mental Capacity
Dr Steven Hemblade
Dr Robert Molloy
Mrs Louise Tweedie
Nurse palliative care
Dr Piers Longhorn
Dr Andrew Conway Morris
Critical Care Physician
Dr Mike Hone
Miss Kathryn Griffin
Vascular surgery
Dr John Cosgrove
General Practitioner Primary health care
Dr Helen Fowles
Respiratory Medicine
Mrs Kirsty Rickards
Medical secretary and receptionist GP General practice
Dr Andrew Lumsden
Dr Paul Cacciottolo
Mrs Paula Read
Dr Vivienne Madden
Dr Ram Amb
Dr Emma Burkitt Wright
Specialist Registrar Clinical Genetics
Mrs Aisling Clarkson
Critical care sr sister -research Critical care/major trauma
Dr Nicola Goodall
Dr Sarah Matthews
Dr Graham Kramer
Dr Laura-Jane Smith
Respiratory Registrar ST4
Dr David Jones
Dr Tom Heath
Mr Thomas Cox
Dr Laura Stirling
Dr David Weinstein
Mrs Heather Davy
District Nurse/ Community Matron
Dr Steven Kinnear
Acute Physician and Medical Manager
Dr Pam Wynne
Dr Jamie Wallis
GP Registrar
Dr Matthew Broome
Dr Paul Emery
Dr Amy Davidson
Dr Toby Hillman Hospital
Dr Muhammad Ahsan Hospital
Mr Terry Irwin
Ms Marion Dickson
Dr Anne Marie Cunningham
Dr Charles West Medicine
Ms Donna Cooper
Health care worker Brain injury
Miss Amy Bell
Staff nurse Oncology/palliative care
Miss Nicola Pender
CEO Medical Education
Dr Martin Brunet
General Practitioner Primary Care
Dr Tim Blake
Dr Payam Torabi
GP Trainee
Dr Chris Roseveare
Hospital consultant Acute medicine
Dr Aseem Rahman
Dr Paul O’Grady
Mrs Rachel Bodil
Staff nurse
Dr Daniel Aston
Anaesthetics / ITU
Dr Dean Burns
Mrs Jennifer Morrison
Dr David Nicholl
Consultant Neurologist
Mrs Lynne Scott
Senior Nursing Sister PICU
Mrs Liz Price
Dietitian Oncology
Miss Alison Saunders
Student nurse
Dr Seamus Bradley
Dr Simon Thompson
Dr Kimberley Kendall
Dr Gbenga Afolabi
Respiratory consultant
Dr Willa Mcdonald
Dr Amrit Bhatia
Dr Philip Berry
Consultant Physician General Medicine, Gastroenterology
Miss Alison McCoubrey
Dr Alison Bacon
Palliative Medicine
Dr Hussain Gandhi
Dr Catherine Williams
Miss Michelle Watt
Nurse Older people’s care
Mr James Goodyear
Healthcare Manager
Miss Elizabeth Ferris
Registered Nurse
Dr Laura Walters
Dr Karen Macarthur
Miss Hannah Long
Nurse ITU
Dr Elin Roddy
Consultant Respiratory Physician
Mr Andrew Kennedy
Consultant Surgeon Upper Gastrointestinal Surgery
Mr Robert Pettifer
Pharmacist Community
Miss Gemma Summons
Medical Student
Ms Sharon Gill
Clinical nurse specialist hospice
Dr Claire Wilson
Dr Daniel Sommer
Dr Katie Marley
Dr James Cave
Mr David Buttery
Anaesthetic Practitioner Critical Care
Dr Jacob Eyers
Dr David Watkin
Dr Natalie Silvey
ACCS CT1 West Midlands
Miss Kirsty Walker
Dr Sherif Khalifa
Junior Doctor (CT1) Surgery
Credit: The Telegraph Newspaper

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