RCUK responds to new report on the effect of the COVID-19 pandemic on the UK’s nursing and residential homes

The Queen’s Nursing Institute (QNI) has today published a new report on the effect of the COVID-19 pandemic on the UK’s nursing and residential homes.

The report is based on the results of a survey completed by 163 members of the Care Home Nurse Network, launched in the early weeks of the COVID-19 pandemic.

We welcome the report as it provides insight into the effects of COVID-19 in a number of areas for those working in the nursing and residential home sector.

16 respondents (10% of those surveyed) reported negative changes during the pandemic, which they found challenging. This included experienced GPs, Clinical Commissioning Groups and hospital trusts making cardiopulmonary resuscitation decisions without first speaking to residents, families and care home staff, or trying to enact ‘blanket’ ‘do not attempt cardiopulmonary resuscitation’ (DNACPR) decisions for whole groups of people.

39 respondents reported COVID-19 as a positive focus for change in talking about the care people would want towards the end of their life. One such change is organisations considering moving to introduce the Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) process as a way to support conversations with individuals about what really matters to them.

Responding to the publication of the report, Sue Hampshire, Director of Clinical and Service Development at Resuscitation Council UK said:

“Resuscitation Council UK recognises the importance of personalised emergency care planning and decisions around cardiopulmonary resuscitation. Any such discussions and decisions should be handled sensitively and follow well-established processes. That is why we have worked so hard over recent years to develop the ReSPECT process and to get it adopted by health and social care organisations in many communities.

“While we appreciate that the COVID-19 pandemic has put unprecedented strains on the UK’s health and social care system, we oppose a blanket approach to decisions on whether to attempt cardiopulmonary resuscitation in an emergency.

“It is concerning that some respondents to the survey reported negative experiences of decisions relating to cardiopulmonary resuscitation that did not involve individual residents themselves or their families. However, it is reassuring that some respondents reported COVID-19 as a positive focus for change in talking about end of life care.

“The ReSPECT process supports professionals, patients and / or their families having a sensitive and person-centred conversation to make a plan for a future emergency in which they may not be able to communicate this information themselves.

“The ReSPECT process supports the important principle of personalised care and aims to develop a shared understanding of the patient’s condition, the outcomes the patient values and those they fear and then how realistic treatments and interventions, such as cardiopulmonary resuscitation, fit into this.

“In the next few weeks, we will be introducing an updated version of the ReSPECT form used to guide and document discussions and decisions using the ReSPECT process.

"The changes we have made reflect individual and focus group feedback from professionals, patients and their families both before and during the COVID-19 pandemic. The new version of the form aims to support even more individualised conversations. This reaffirms our commitment to person-centred approaches to emergency care planning and decision-making around cardiopulmonary resuscitation.”

For more information on ReSPECT, visit: www.resus.org.uk/respect.