The National Institute for Health and Care Excellence (NICE) provides national guidance and advice to improve health and social care in the UK.

In response to the Neuberger report and the demise of the Liverpool Care Pathway, new evidence based guidelines have been developed.

This guideline includes recommendations on:

• recognising when people are entering the last few days of life
• communicating and shared decision-making
• clinically assisted hydration
• medicines for managing pain, breathlessness, nausea and vomiting, anxiety, delirium, agitation, and noisy respiratory secretions
• anticipatory prescribing

In my state, Victoria Australia, the VEC (Victorian End of life Coordinating Program) is undertaking similar work, and plans to release a Victorian end of life care plan soon.

In Australia, we have not had the negative stories and experiences seen in the UK; because the LCP was implemented in a better way? The stories coming out of the Neuberger report were shocking: I cannot imagine any patient being denied a drink when requested “because she is on the LCP”. However the LCP has also been withdrawn locally in response to the negative findings delivered in the UK.

I will be participating in a pilot of the new end of life care plans which will replace the LCP locally. I am looking forward to seeing the final version.

Thoughts, dear reader, about the terminal care of the LCP?