Editor -Edmonds and Rogers's recent paper on the review of the care of patients dying in hospitals (Clin Med March/April 2003, pp 149-152) referred to the Liverpool Care of the Dying Pathway 1 as a strategy to enhance the care of dying patients. However, they also state that there is no evidence at present that the use of the pathway in the hospital setting improves the exchange of information and communication between patients, carers and healthcare professionals at the end of life. We would

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... ke to clarify that an evaluation of the impact of the Liverpool Care of the Dying Pathway is underway and that there is a growing body of evidence to suggest that the pathway does promote communication and information exchange. It has now been adopted in over 120 settings in the UK and has been incorporated into the National Cancer Services Collaborative Improvement Programme. Informal feedback from doctors and nurses using the pathway has been positive, with enhanced communication being regularly cited. A recent evaluation of the views of healthcare professionals using a focus group methodology has indicated that the pathway promotes an openness and honesty in communication between patients, relatives and healthcare professionals. This enhanced communication is reported as being beneficial for patients, relatives and the doctors and nurses. Additionally the pathway documentation emphasises a continuity of care that follows evidence-based guidelines. The findings also indicated that the prescribing guidelines and after death local information contained in the pathway were an invaluable source of information for doctors and nurses. 2 The findings to date suggest that the Liverpool Care of the Dying Pathway has a positive impact on helping to provide optimal care for dying patients in the hospital setting. Further evaluation of the impact of the pathway on doctors, nurses, patients and carers is underway.