NHS: Liverpool Care Pathway

Debate between Earl Howe and Lord Bishop of Exeter

Tuesday 15th January 2013 Lords Chamber

[Earl Howe]

I am grateful to my noble friend for drawing attention to a very important point. It has always been emphasised in connection with the LCP that to ensure that it is used properly it is important that staff receive appropriate training and support, and that relevant education and training programmes are always in place. In view of the degree of staff turnover to which my noble friend refers, I am confident that the noble Baroness, Lady Neuberger, will have that fact in her sights.

[The Lord Bishop of Exeter]

My Lords, does the noble Earl agree that if there is to be full confidence in what is undoubtedly a useful clinical tool that has helped many thousands of people to experience better care in the last hours and days of their life, non-clinical priorities in the use of the pathway, especially financial priorities, must be eradicated, and every patient should be treated solely according to their needs? Does he further agree that it would be far better to link CQUIN payments to staff training in the use of the pathway, rather than the numbers of patients being placed upon it?

[Earl Howe]

My Lords, once again, I am sure that the noble Baroness, Lady Neuberger, will wish to look at that very issue. The CQUIN payment framework that the right reverend Prelate mentioned was designed to incentivise good practice, and the LCP is considered internationally to be best practice. In one sense, it is therefore logical that the two should be combined. It is equally important for me to emphasise that the Department of Health has not attached any set financial targets to the LCP; on the other hand, some commissioners in the NHS have introduced local incentives. The way in which those incentives have been applied should be the subject of close attention.

Older People: Health and Social Care

Debate between Earl Howe and Lord Bishop of Exeter

Monday 18th June 2012 Lords Chamber

[Earl Howe]

The noble Baroness makes a very fair point. As I made clear last week, our aim has been and remains to legislate in this Parliament to create a fairer, more just and better funding system for social care.

[The Lord Bishop of Exeter]

Given that Delivering Dignity recommends that,

“All hospital staff must take personal responsibility for putting the person receiving care first”,

and that staff “should be urged” to challenge practices that they believe are not in the best interests of residents, what measures have Her Majesty’s Government taken to support staff who whistleblow in this respect?

[Earl Howe]

My Lords, the right reverend Prelate draws attention to an area that we have focused on quite hard in recent months, and the NHS constitution has been changed to strengthen the areas around whistleblowing. In the care home context, often the care home is looking after someone who is not publicly funded and the arrangements there are often ones that the care home itself has put in place. We believe that the CQC needs to focus carefully on the arrangements in the care homes that it inspects to ensure that staff feel free to speak up if they are aware of any problems of maltreatment or anything of that kind.