Reassurance on care for dying in NZ

KELSEY FLETCHER
Last updated 12:44 20/07/2013

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The Ministry of Health is confident end-of-life care in New Zealand will not be affected by a damning review from the United Kingdom.

The Liverpool Care Pathway for dying patients is used in hospices, hospital-level residential care facilities and hospitals in more than 20 countries to improve care given to dying patients. It has been used in New Zealand since about 2004.

However, it will be phased out in the UK after an independent review found it was failing dying patients and their families.

Ministry of Health cancer services manager Ricarda Vandervorst said the way the pathway operated in the UK was different to how it was implemented in New Zealand.

"In New Zealand, it is one tool used to guide end-of-life care in hospices, hospital-level residential care facilities and hospitals across New Zealand," she said.

"Here, the focus is on using the pathway tool as a component of an integrated approach to quality palliative and end-of-life care, supported by specialists and other health professionals. It is not intended to replace clinical judgment and practice."

Vandervorst said the independent review found flaws in the way the pathway was being delivered, including poor implementation and worrying standards of care.

"In the UK, hospitals were offered financial incentives, unlike New Zealand, to use the pathway as a way of encouraging them to treat dying patients in accordance with best practice," she said.

"The review found that many families considered this practice distressing and interpreted it as a bonus for hastening the death of their loved ones."

Vandervorst said the ministry was not aware of issues in New Zealand similar to those raised in the review.

Palmerston North-based Arohanui Hospice chief executive Clare Randall said Arohanui would continue to provide the same palliative and end-of-life care to patients and families across the region.

"Our education programme which extends to all providers of palliative and end-of-life care in primary and secondary care will continue," she said.

"I have met with the Palliative Care Council and the Ministry of Health in my role as a member of the Palliative Care Advisory Group and the report was discussed in this forum. I have also been in touch with the United Kingdom and will be kept up to date with information as it becomes available."

Vandervorst said the ministry was aware the pathway would be phased out in the UK over the next six to 12 months and was considering the implications for New Zealand.

"The Ministry of Health is writing to district health boards to remind them that the pathway should be used as part of an integrated and collaborative approach involving the lead clinician, team, patient and family in care planning and decisions around care," she said.

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- Manawatu Standard

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