Submission to the Neuberger review of the Liverpool Care Pathway and Meetings with Marie Curie , John Ellershaw.

Dr. Lofthouse made this Freedom of Information request to Parliamentary and Health Service Ombudsman

This request has been closed to new correspondence from the public body. Contact us if you think it ought be re-opened.

The request was partially successful.

Dear Parliamentary and Health Service Ombudsman,

I have a series of questions under the FOI Act arising from your submission to the Neuberger review, dated 13th April 2013, a copy of which is available online here: http://www.ombudsman.org.uk/__data/asset...

1. In this submission, you mention a meeting between Prof. John Ellershaw 'last year' (ie 2012) in connection with complaints about End of Life Care.

Mr. Ellershaw is the author of the Liverpool Care Pathway, and an employee of Marie Curie, who own copyright to this pathway.

Request 1: could you supply a copy of all tape recordings or minutes, or notes taken at this meeting, and communications between your office and this organisation in connection with the liverpool care pathway, or at least supply a reason for holding this meeting at all, and the questions you raised please?

Request 2: Two versions of the Liverpool Care Pathway have been implemented across the NHS, and rolled out to 22 EU and other non EU countries since 2003, bearing a Dept. of Health recommendation. Version 12 was launched in 2010.

Version 11 had no consent process attached, had a poorly defined 'ethnicity ' tick box, and did not even ask if the patient and relatives could speak English until AFTER all treatments food and fluids had been withdrawn,and a syringe driver containing Diamorphine, Midazolam and Cyclizine had been started. It had no advice on 'communicating' with patients or relatives whatsoever, and had no 'consent' process attached. It advised that the LCP be initiated if patients met two of the following 4 criteria: 'semicomatose, bed bound, unable to swallow tablets, taking only sips of fluid'. These criteria indicate no 'informed consent' (as defined by the Mental Capacity Act 2005 and its Code of Conduct) could have been obtained from ANY patient placed on it.

The Mental Capacity Act Code of Conduct came into force in England on October 1, 2007. This required a 'test of competency' to be conducted before consent to any form of medical intervention.

The LCP v.11 did not contain any provision for either a test of competency to give consent, or consent, and hence a DoH-recommended care pathway was in use UNLAWFULLY across the NHS from Oct. 1st, 2007 - implementation date for LCP v.12 in 2010.

The provision of End of Life Care in the NHS was therefore in breach of Criminal Law (ie the Mental Capacity Act) from Oct. 1st 2007- 2010. Moreover, the DoH endorsed and recommended an ILLEGAL care pathway for this entire time period.

I note that for some reason, in your submission to the Neuberger Review, you only included complaints from 2010 onwards.

Request 2: could you explain why you confined the cases included in your submission to those made AFTER 2010? Were you advised to by the Department of Health or NHS, or even Baroness Neuberger to do so?

Request 3: I note that you have failed to make any submission regarding the ILLEGALITY of this government-recommended 'care pathway' to the House of Lords inquiry into the Mental Capacity Act[http://www.parliament.uk/business/lords/.... In view of the fact you must be aware that the Liverpool Care Pathway breached UK statute, can you explain the reasons for NOT making a submission in this regard?

Thank you.

Yours faithfully,

Dr. Lofthouse

foiofficer, Parliamentary and Health Service Ombudsman

Thank you for your e-mail to the Parliamentary and Health Service
Ombudsman. This return e-mail shows that we have received your
correspondence.

show quoted sections

All email communications with PHSO pass through the Government Secure
Intranet, and may be automatically logged, monitored and/or recorded for
legal purposes.
The MessageLabs Anti Virus Service is the first managed service to achieve
the CSIA Claims Tested Mark (CCTM Certificate Number 2006/04/0007), the UK
Government quality mark initiative for information security products and
services. For more information about this please visit www.cctmark.gov.uk

Dr. Lofthouse left an annotation ()

... at what point does poor care becomes abuse under section 44 of the Mental Capacity Act?

D. Speers left an annotation ()

Good question!

foiofficer, Parliamentary and Health Service Ombudsman

4 Attachments

Dear Dr Lofthouse

 

Your information request

 

I write further to your information request of 6 July 2013. You have asked
3 questions relating to the Liverpool Care Pathway and the Ombudsman’s
submission to the Neuberger review. I will address each of your questions
in turn.

 

Could you supply a copy of all tape recordings or minutes, or notes taken
at this meeting [between PHSO staff and Prof John Ellershaw], and
communications between your office and this organisation in connection
with the liverpool care pathway, or at least supply a reason for holding
this meeting at all, and the questions you raised please?

 

Please find attached the only information we hold relating to the meeting
between PHSO and Prof Ellershaw. This is an email chain arranging the
meeting and a note about what was discussed at the meeting.

 

However, I have redacted the contact telephone numbers for the staff
involved and their email addresses. This has been withheld under section
40 (2) because it is their personal information.

 

Could you explain why you confined the cases included in your submission
to those made AFTER 2010? Were you advised to by the Department of Health
or NHS, or even Baroness Neuberger to do so?

 

In order to ensure that the information we submitted was clear,
accessible, and relevant, we decided to provide the number of complaints
we had received about the Liverpool Care Pathway since 2010/11.

 

I note that you have failed to make any submission regarding the
ILLEGALITY of this government-recommended 'care pathway' to the House of
Lords inquiry into the Mental Capacity
Act[http://www.parliament.uk/business/lords/....
In view of the fact you must be aware that the Liverpool Care Pathway
breached UK statute, can you explain the reasons for NOT making a
submission in this regard?

 

The Health Service Ombudsman considers complaints that the NHS has
provided a poor service or treated people unfairly. In keeping with our
role, the submission we made to the Neuberger review reflected what the
complaints we have seen have told us about the Liverpool Care Pathway, its
implementation, and the situations giving rise to complaints.

  

Yours sincerely

 

 

 

 

Luke Whiting

Head of Freedom of Information and Data Protection Team

Parliamentary and Health Service Ombudsman

E: [1][email address]

W: [2]www.ombudsman.org.uk

 

Follow us on

[3]fb  [4]twitter  [5]linkedin

 

 

show quoted sections

All email communications with PHSO pass through the Government Secure
Intranet, and may be automatically logged, monitored and/or recorded for
legal purposes.
The MessageLabs Anti Virus Service is the first managed service to achieve
the CSIA Claims Tested Mark (CCTM Certificate Number 2006/04/0007), the UK
Government quality mark initiative for information security products and
services. For more information about this please visit www.cctmark.gov.uk

References

Visible links
1. mailto:[email address]
2. http://www.ombudsman.org.uk/
http://www.ombudsman.org.uk/
3. http://www.facebook.com/phsombudsman
4. http://www.twitter.com/PHSOmbudsman
5. http://www.linkedin.com/company/parliame...

Dr Lofthouse left an annotation ()

You also have , as part of your remit, complaints about the Department of Health.
From your response to this complaint, you appear to have been 'advised' by them to contact the people responsible for the liverpool care pathway (Marie Curie in Liverpool)- you also appear to have been advised to limit complaints to the time period in which LCP v.12 was in use. I shall therefore resubmit the complaint as a complaint about the DoH failing to order a judge-led inquiry into the fact that from Oct.2007 -Dec. 2009, LCP v.11 was in use across the entire NHS , despite having no adequate consent process attached, in clear breach of the 'informed consent' requirements demanded by the MCA 2005.