Background The Liverpool Care Pathway was abolished in 2014 following widespread criticism. Since then there has been a focus on local personalised care plans for dying patients.
Objectives The aim of the study was to evaluate the number of patients placed on a personalised end-of-life care plan (PELiCan) during a 5 year period. Then to identify the number of patients removed from a PeLICan. Finally to identify whether removing a patient from an end-of-life care plan was appropriate (the patient was not in the final 7 days of life). By analysing this data we hope to guide and improve our future palliative care practice.
Methods A retrospective study looking at patient information collected from electronic records of all patients started on a PELiCan at The Royal Surrey County Hospital. Inclusion: all patients placed on a PELiCan from August 2015 to July 2020. Patients removed from a PELiCan were evaluated further to assess their outcome.
Results 2465 patients were placed on a PELiCan over 5 years. Overall 2424 patients were included in the study. 94% of patients who started a PELiCan remained on this until death. 157 (6%) patients were taken off a PELiCan. Following removal of PELiCan 28% of patients died within 7 days. Overall the majority of patients had a non-cancer diagnoses. 682 (28%) patients placed on a PELiCan had a primary diagnosis of cancer. Similarly in those removed from a PELiCan 24% had a cancer diagnoses.
Conclusion Number of patients placed of end-of-life care plans has increased within our trust since 2015. A small proportion of patients were removed from personalised end of life care plans. These patients represent a known group of individuals high risk for deteriorating requiring palliative care input and follow up. Based on this we have introduced a palliative review process for these patients.
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