The ReSPECT Process

Information for patients and carers

What is ReSPECT?
ReSPECT stands for Recommended Summary Plan for Emergency Care and Treatment. The ReSPECT process creates a personalised recommendation for your clinical care in emergency situations where you are not able to make decisions or express your wishes.

This plan 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.  

The plan is created through conversations between you and your health professionals. The plan stays with you and should be available immediately to health professionals called to help you in an emergency, whether you are at home or being cared for elsewhere. Professionals such as ambulance crews, out-of-hours doctors, care home staff and hospital staff will be better able to make quick decisions about how best to help you if they can see your ReSPECT form in an emergency.

The ReSPECT process is designed to support conversations between you and your health professionals (and other people important to you) in order to understand your priorities of care and use those to develop an agreed plan that records what types of care or treatment:

  • you would want to be considered for in an emergency
  • you would not want to receive
  • would not work or be of overall benefit to you.

It is important to understand that the ReSPECT form cannot be used to demand treatments that are not likely to benefit you and would not be offered.

In an emergency where you are not able to make decisions or express them, clinical decisions will be made by health professionals trying to act in your best interests and for your benefit.

In an emergency, health or care professionals may have to make rapid decisions about your treatment, and you may not be well enough to discuss and make choices. This plan empowers you to guide them on what treatments you would or would not want to be considered for, and to have recorded those treatments that could be important or those that would not work for you. Many treatments that can be life-sustaining for some people carry a risk of causing harm, discomfort or loss of dignity. Many people choose not to accept that risk if the likelihood of benefit from treatment is small. This plan is to record your preferences and agreed realistic recommendations for emergency situations, whatever stage of life you are at.

ReSPECT was initially introduced in some localities as part of a formal research evaluation taking place over three years. Alongside this, a network of health and care communities that are adopting and implementing the process is developing. Implementation will be a gradual process, with different health communities adopting and implementing ReSPECT using different timeframes, according to local or regional circumstances. 

If ReSPECT has already been adopted in your locality then you will be able to work with your health care professional to develop a form.

We have a map which shows towns in which there has been some adoption of ReSPECT.

However, if ReSPECT has not been established in your locality, but you would like to take steps now to ensure your wishes for treatment and care are known about, then you could make an Advance Decision to Refuse Treatment (ADRT). You can find out more information and fill out an ADRT for free online at www.mydecisions.org.uk.

You can download further information about the ReSPECT process below. Once ReSPECT has been adopted and introduced in your locality, your local healthcare team will be able to guide you further.

Why the ReSPECT process is needed