RCUK Statement on ‘What Matters Most Charter’

RCUK welcomes the ‘What Matters Most Charter,’ a new initiative which encourages a series of life-affirming conversations enabling a person’s wishes to help them live as well as possible until death.  
We are pleased to have worked with the RCGP EOL Think Tank to develop this charter and film entitled “What Matters Most.’ The charter and film incorporate the principles of the ReSPECT process, where conversations lie at the heart of creating compassionate and meaningful emergency care plans that respect the wishes of the person.  
Often, emergency care planning is focused around what not to do - what interventions to avoid and what treatments not to start. These are important questions, but they do not ask people at the end of life what matters to them, and how they want to live well with the time they have left, rather than how they want to die. 
Health professionals are often reluctant to ask Advance Planning questions and this is reflected in poor completion rates, with sometimes as low as 5% of people who die having an Advance Care Plan in place. 
These issues have been further highlighted by the Covid-19 pandemic, and in response the Royal College of General Practitioners brought together organisations and people involved in end of life care, including Resuscitation Council UK, along with Compassionate Communities, Marie Curie, the Royal College of Nursing, Association of Palliative Medicine, Macmillan, Hospice UK and others to find a solution. 
This work has produced a new charter and a film calling for a better approach to Advance Care Planning. The film reflects that if peoples’ wishes are heard and respected, they can live better until the very end of their lives. 
This is a belief at the heart of ReSPECT, a process that creates personalised recommendations for a person’s clinical care and treatment in a future emergency in which they are unable to make or express choices. These recommendations are created through conversations between a person, their families, and their health and care professionals to understand what matters to them and what is realistic in terms of their care and treatment. Patient preferences and clinical recommendations are recorded on a non-legally binding form which can be reviewed and adapted if circumstances change. 
The ReSPECT process can be for anyone but will have increasing relevance for people who have complex health needs, people who are likely to be nearing the end of their lives, and people who are at risk of sudden deterioration or cardiac arrest. Some people will want to record their care and treatment preferences for other reasons. 
Having meaningful conversations around what matters to someone can make the difference between a peaceful, meaningful ending and a confusing, frightening one. It can make the difference between family and friends feeling satisfied they did everything they could for their loved one, and the uncertainty and guilt of not knowing if they got it right, leading to complex grief.  
You can watch this free film and read more about the importance of conversations by visiting www.whatmattersconversations.org and learn more about how the ReSPECT process shapes emergency care planning at resus.org.uk/respect