Decision Report 201204749

Summary

Mr C complained about the care and treatment that district nurses provided to his late mother (Mrs A) before her death. He said that they had not taken reasonable steps to assess and monitor Mrs A's pain when changes were made to her medication. He also said that they unreasonably put Mrs A on the Liverpool Care Pathway (a framework used by healthcare professionals in the last hours or days of life when a death is expected).

We took independent advice on Mr C's complaints from a nursing adviser and a medical adviser. After doing so, we did not uphold the complaints. Our advisers said that the district nurses had assessed Mrs A's pain appropriately and in line with guidance. We found that Mrs A's level of pain had been assessed at every visit, the family had information on what to do if they had concerns about her, and that it had been reasonable that the nurses had not used a pain assessment tool. The decision to put Mrs A on the Liverpool Care Pathway was predominantly made by a GP and a palliative care nurse, although it did involve discussion with family members and the district nurses. We found that, on balance, the decision to start the Liverpool Care Pathway had been reasonable and we did not identify any failings by the district nurses in relation to this decision. We found that it had been completed and implemented appropriately and that communication with Mrs A's family had been reasonable.