As part of a continuing engagement with the issues surrounding the LCP, Care Not Killing has responded to the official review being led by Baroness Neuberger. The review's terms of reference stressed that 'the issue is... not about the merits of the LCP itself, but about how it is being used'. We agreed that the LCP is a valuable tool which has helped many thousands of patients to experience reduced pain and distress at the end of life, and it is essential that misapplication should not mean the loss of a protocol which continues to benefit people right round the country.

Among CNK's key concerns were:

• the "comprehensive failure to explain and defend the protocol", including a failure to emphasise to both public and healthcare professionals that the LCP calls for care to "not be given in a blanket fashion but carefully individualised for each patient."
• the failure "to reassure a general public confronted with unrepresentative horror stories in the press", in stark contrast with "successive audits [which] have demonstrated overwhelming support for the LCP from families... [these] ought to have been more strongly challenged to maintain trust in clinical judgement and in protocols with strong track records."
• and that "implementation is impacted or influenced by insufficient training, inadequate supervision by senior staff and pressure from clinical management... [as well as issues] relating to continuity of care".

An updated version of the proposals CNK published at the time of Minister Lamb's roundtable talks last year was then commended to the review panel.

Written submissions have now closed, but sessions for families and carers in London, Preston and Bristol have been announced.