Resuscitation Council UK welcomes the Department of Health and Social Care’s commissioning of the Care Quality Commission to review the use of DNACPR during the COVID-19 pandemic.
While we appreciate that the COVID-19 pandemic has put unprecedented strains on the UK’s health and social care system, we have been deeply concerned by reports of people being subjected to DNACPR decisions without their consent or with little information to allow them to make an informed decision during the pandemic We do not condone such practices.
We believe strongly in the importance of personalised, anticipatory 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 across the UK.
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.
A person’s ReSPECT form includes recommendations about emergency treatments that could be helpful and should be considered, as well as those not wanted by or that would not work for the patient. It includes a recommendation about CPR, but that may be a recommendation that CPR is attempted, or a recommendation that it is not attempted.
We hope that CQC’s review will explore areas of concern as well as best practice around anticipatory care planning and decision making around cardiopulmonary resuscitation. We want to see every regulatory health and social care body provide clear recommendations to ensure that patients and their families experience consistent, high quality, person-centred discussions and decision making around this complex area, wherever they live across the UK.