Poor communication about end of life care

What happened

Mr G had leukaemia. In late summer 2012, the Trust treated Mr G in hospital for the leukaemia and for sepsis.

Unfortunately, despite treatment, Mr G's condition did not improve, and so medical staff made the decision to stop active treatment and start him on the Liverpool care pathway (an end of life pathway no longer used by the NHS).

His wife, Mrs G, and his daughter, Mrs L, complained to the Trust and the family met Mr G's consultant to discuss their concerns. In particular the family complained that the Liverpool care pathway had not been explained to them. They said that if it had been, they and Mr G would not have agreed because of their religious views. They were also concerned that the Liverpool care pathway and the drugs Mr G was given may have hastened his death.

The Trust accepted that there were problems in the communication with the family. For example, staff did not give them a booklet about the Liverpool care pathway, which they should have. However the Trust said that Mr G's clinical management had been reasonable. Mrs L remained unhappy and asked us to investigate.

What we found

There were no failings in Mr G's clinical management and we were satisfied that, from a clinical perspective, the decision to start him on the Liverpool care pathway was appropriate. There was no evidence that his death was hastened by this decision or by the medication given to him.

However, communication with Mrs L and her family, in particular about the Liverpool care pathway, was inadequate, so the family did not fully understand the implications of what staff proposed. This caused Mrs L's family a great deal of distress and left Mr G's wife with strong feelings of guilt about his death.

Putting it right

The Trust apologised to Mrs L and acknowledged the failings in communication we identified.

The Trust gave Mrs L an update on the various measures it had taken to improve communication.