US firm IHI paid for dying hospital patients project

AN AMERICAN healthcare giant has been paid thousands of pounds of public money to help create new guidelines for dying hospital patients in Scotland.

Jackson Carlaw PA

Scottish Conservative health spokesman Jackson Carlaw spoke out about the plans

Ministers have scrapped the controversial Liverpool Care Pathway, which was heavily criticised for a lack of compassion towards people in their final hours.

Now it has emerged the Scottish Government asked the Boston-based Institute for Healthcare Improvement (IHI) to look into a replacement policy for end of life care.

A pilot project has been set up based on IHI's 'Conversation Ready' programme, which encourages people to talk with their families and medical staff about how they want to die.

IHI staff have been working alongside the Scottish Partnership for Palliative Care (SPPC) to oversee palliative care trials in hospitals in Grampian, Lanarkshire and Lothian.

The Lanarkshire trial involved dying patients at Wishaw General Hospital, although in one case the family was left "very angry" after a 78-year-old man with bronchopneumonia was given the wrong treatment.

All of the results - including sensitive personal data - have been shared with "colleagues" at IHI headquarters in Cambridge, Massachussets. 

Professor Craig White, chair of the National Advisory Group for Palliative and End of Life Care, wrote to health board bosses last year to announce the project.

He said: "We have recently provided funding to support engagement of test sites with the Institute for Healthcare Improvement (IHI).

"NHS Lothian, Grampian and Lanarkshire colleagues will be working with Faculty from IHI to inform future work specifically relating to care in the last days and hours of life."

Although the fee paid to IHI for the pilot projects was less than £10,000, with a further £50,000 going to the SPPC, it sheds further light on the organisation's extraordinary influence in Scotland.

Alongside NHS Scotland, the other members of the organisation's palliative care programme are all American private sector hospitals and health projects.

IHI wants people to discuss their wishes for end of life care "around the kitchen table" with their loved ones rather than wait until they are "in the midst of a health care crisis".

NHS Lothian, Grampian and Lanarkshire colleagues will be working with Faculty from IHI

Professor Craig White

However, this open approach to such a personal issue is unlikely to fit comfortably with the reserved Scottish psyche - with death still regarded as the last great taboo.

The results from all the participants will be discussed at a seminar in Boston next month, although it is not known whether any Scottish health officials plan to attend.

Last night, Scottish Conservative health spokesman Jackson Carlaw said: "Patients and staff will be puzzled as to why the SNP is commissioning a private firm to undertake work surely our own experts are capable of.

"It has to be remembered that attitudes to this issue in the US are quite different to here.

"This also makes a mockery of the SNP's pathetic stance during the referendum that it would save the NHS from what it deemed privatisation.

"In fact, it is just as happy to rely on the independent sector as anyone else." 

The Liverpool Care Pathway was devised by medics in the city in the 1990s and aimed to prevent the unnecessary prolonging of life for those in severe pain or with no prospect of recovery.

However, a review found that in many cases nursing staff wrongly believed that a dying patient should not be given any fluids and families were often not told a relative had been put on the pathway.

As this newspaper revealed last week, IHI has been paid almost £6million by the SNP since 2007 to introduce sweeping reforms across the NHS in Scotland. 

Cementing the relationship, former NHS Scotland chief executive Derek Feeley quit in April 2013 to become executive vice president of the not-for-profit organisation.

A spokesman for the Scottish Government said: "It is absolutely essential that the wishes of patients and their families are taken into account when planning for end of life care.

"The Conversation Ready project focussed on finding ways to help teams to organise and co-ordinate care for people with incurable conditions.

"Learning from the programme is now being collated to inform further improvement to services."

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