RCUK welcomes the news that Matt Hancock, the Secretary of State for Health and Social Care, has made a commitment to publish clearer guidance around DNACPR as soon as possible. We have heard too many stories of patients being pressured into agreeing not to have cardiopulmonary resuscitation attempted without any sense of shared decision-making or understanding of the relevance for them.
We voiced our concerns about this early on in the pandemic.
We hope the Government’s guidance will encourage health and social care organisations to use the ReSPECT process. The ReSPECT process supports professionals, patients and / or their families having a carefully constructed and person-centred conversation around emergency care planning, which has patient choice at its heart.
Any decision making around DNACPR should be achieved through a well-structured conversation between healthcare professionals and the patient about their care, that aims to develop a shared understanding of the patient’s condition, the outcomes the patient values and those they fear and then how treatments and interventions, such as cardiopulmonary resuscitation fit into this.
Significant distress can be caused to patients and their families if they are worried they will not receive urgent and appropriate care and treatment if they suddenly become gravely unwell. The fact that a DNACPR recommendation should not affect any other aspect of appropriate person-centred emergency assessment and care is not well understood.
We understand that the guidance will be produced by NHS England and Improvement and will make clear that patients and their family should be involved in conversations about cardiopulmonary resuscitation, and how to request a review. Guidance to NHS Trusts will outline the process they should follow, including how to escalate concerns where there is no agreement.
To find out whether the ReSPECT process has been adopted in your area, or for information on how to adopt the process in your area, contact info@respectprocess.org.uk
Sat, 18/07/2020