The ReSPECT (formerly known as ECTP) Working Group was established in February 2015 to work collaboratively and build on major work already undertaken to develop a national form to record anticipatory decisions about CPR and other life-sustaining treatment, and to guide decision-making in an emergency situation in which the person lacks capacity.
The aims of the Working Group are to:
- establish the scope of the project and any resulting documents;
- identify and review examples of evidence-based best practice (national and international)
- involve patient and carer groups and other relevant stakeholders;
- collaborate and contribute to developing a national form that is easy to recognise and records anticipatory decisions about CPR and about other aspects of a person’s care or treatment if they become unwell (including but not limited to other life-sustaining treatment) in the context of a broader plan;
- ensure that the form is person-centred and can be used for all individuals of all ages;
- ensure that the form is developed with input from a wide range of stakeholders and is acceptable to patients, those important to them, healthcare professionals, carers and other members of the public;
- plan the implementation to ensure that the form crosses geographical and organisational boundaries and is recognised in a full range of healthcare settings;
- develop plans to reduce the current negative perception of DNACPR decisions and to achieve public engagement for successful implementation and acceptance of a national form;
- establish realistic timelines for development, pilot of, and implementation of the national form.
Two Co-Chairs (David Pitcher from the RC (UK) and JP Nolan from the RCN) were selected from members of the Working Group to represent a broad spectrum of interests. There is no limit to the number of members but this should be kept to a manageable number. Representation will be invited from the following:
- Resuscitation Council (UK)
- British Medical Association
- Royal College of Nursing
- Association for Palliative Medicine
- Royal College of Paediatrics and Child Health
- Intensive Care Society
- General Medical Council
- Nursing and Midwifery Council
- Association of Ambulance Chief Executives/JRCALC
- Royal College of General Practitioners
- Royal College of Anaesthetists
- Royal College of Physicians
- Royal College of Surgeons
- College of Emergency Medicine
- Paediatric Intensive Care Society
- Community Nursing
- Learning Disability
- Care Quality Commission
- Resuscitation Officer
- Professional Record Standards Body
This list is not exhaustive.
Meetings and working methods
Half-day face-to-face meetings will be held initially, with additional full-day meetings and telephone conference calls/email discussions as required. Face-to-face meetings will normally be held in London at the office of the Resuscitation Council (UK) or Royal College of Nursing. The Co-Chairs will alternate chairing the meetings and be responsible for setting the agenda. The meeting papers will be circulated electronically to the Working Group at least one week in advance of the meeting and members should bring hard copies of the documents to the meeting. Each member will declare and record any personal conflicts of interest (COI), respect confidentiality, and will undertake and promote the activities that are in the best interests of the Working Group. Individual members will be responsible for carrying out tasks delegated to them and for reporting back to the Working Group. The Working Group will provide timely information and publish regular updates on progress.
The method used to arrive at recommendations will be based on review and discussion of the evidence by the Working Group until consensus is achieved. The Chairs must ensure that each individual on the Working Group can present and debate their views, and that discussions are open and constructive. All members of the Working Group must agree to endorse any recommendations. If they cannot achieve consensus, this should be made clear in the final wording of the recommendation. The Working Group will agree the timeline for publication together with a communications strategy.
The RC (UK) and RCN will provide, wherever possible, administrative support and the RC (UK) will pay for reasonable travel expenses for attendance at face-to-face meetings. Where funding is required for major outgoings (such as professional legal fees, development of educational material, additional resources) alternative sources will be pursued by members of the Working Group.