Doctors told to take new approach to care for dying

Sheffield, and one of the authors of the guidelines, said any changes in the treatment of the dying must be taken in consultation with senior staff.

“If the person that thinks someone is dying – it could be a junior doctor in the hospital in the middle of the night with no one to turn to – they should seek advice from a more experienced colleague,” he said.

Care of patients believed to be dying should be reviewed daily, Nice added – with doctors instructed to respond to any signs of improvement.

Although the pathway was supposed to be phased out last year, Prof Ahmedzai said he was fearful that in some hospitals, staff were continuing to follow the much-criticised protocols.

But Prof Patrick Pullicino, one of the first experts to raise concerns about the LCP, said the new advice was as bad as the approach it replaces.

He criticised the attempt in the guidance to identify “signs” that a person might be dying, saying once patients were “diagnosed” as facing death it inevitably meant their treatment was changed and their death more likely.

Nice said the changes were a significant shift which aimed to put the needs of the patient first.

“We are saying we would want to have an individualised approach rather than applying a blanket approach, as would apply using the LCP in an unthinking way,” Prof Ahmedzai said.

The LCP was phased out last year after a review found a “tick-box” culture was leading to people being put on the pathway without the knowledge of their families. Families criticised decisions which led to their loved ones having nutrition and fluid withdrawn.