How does the LCP work

It relies on the prognosis of Death

A PROGNOSIS, or FORECAST, of a patient’s likely progress is given by a member of the medical staff. To be placed on the LCP a forecast of imminent death according to the Core Documentation must be made by the MDT; that is the MULTI DISCIPLINARY TEAM.

The LCP VERSION 12 constantly refers to the MDT’s continuous involvement, but doesn’t say who should be a member of it; here is some advice for hospitals at the weekend FROM THE LCP Version 12

“It is hard to tell if a patient is dying. It is even harder to say if they are in the last days or hours of their life. The LCP takes steps to address this by requiring an assessment to be made by the MDT. However, especially at weekends (and at night) the MDT may be somewhat thin on the ground…there will be nurses, there will be junior doctors, but the number of senior doctors is probably low and there are unlikely to be any other health-care professionals around – pharmacists, physiotherapists, speech therapists (who carry out assessments of a person’s ability to swallow) etc who would normally be considered a legitimate part of the MDT.”

Add to this during the week; specialists in the patient’s condition, senior nurses (Ward Sisters, Matrons),Macmillan nurses, a Social Worker and we can see it’s quite a crowd, if it happens, which it rarely seems to. But we wouldn’t recommend going in at the weekend, try not to ‘swallow’ that one.

Sadly the truth about what actually happens seems a far cry from the guidelines and the required implementations found in Version 12.

People appear to be told that their relative is dying almost out of the blue when they hadn’t expected it or for that matter when the patient did not look to be dying at all.

It’s worth noting that The American Journal of Hospice Care showed that health professionals were wrong 50% of the time in predicting a patient’s survival.