What is ReSPECT?
ReSPECT stands for Recommended Summary Plan for Emergency Care and Treatment. The ReSPECT process creates a summary of personalised recommendations for a person’s clinical care in a future emergency in which they do not have capacity to make or express choices. Such emergencies may include death or cardiac arrest, but are not limited to those events. The process is intended to respect both patient preferences and clinical judgement. The agreed realistic clinical recommendations that are recorded include a recommendation on whether or not CPR should be attempted if the person’s heart and breathing stop.
To learn more about ReSPECT, watch the video below which outlines Joe's journey through the ReSPECT Process.
To browse our supportive resources for health and social care professionals, please visit the ReSPECT resources page.
How does it work?
The plan is created through conversations between a person and one or more of the health professionals who are involved with their care. The plan should stay with the person and be available immediately to health and care professionals faced with making immediate decisions in an emergency in which the person themselves has lost capacity to participate in making those decisions.
ReSPECT may be used across a range of health and care settings, including the person’s own home, an ambulance, a care home, a hospice or a hospital. Professionals such as ambulance crews, out-of-hours doctors, care home staff and hospital staff will be better able to make immediate decisions about a person’s emergency care and treatment if they have prompt access to agreed clinical recommendations on a ReSPECT plan.
What is a ReSPECT conversation?
ReSPECT conversations follow the ReSPECT process by:
- discussing and reaching a shared understanding of the person’s current state of health and how it may change in the foreseeable future,
- identifying what is important to the person in relation to goals of care in the event of a future emergency,
- using that to record an agreed focus of care (either more towards life-sustaining treatments or more towards prioritising comfort over efforts to sustain life),
- making and recording shared recommendations about specific types of care and realistic treatment that should/shouldn’t be given, and explaining sensitively recommendations about treatments that would clearly not work int their situation
- making and recording a shared recommendation about whether or not CPR is recommended.
Electronic ReSPECT plan
If you are interested in developing an electronic ReSPECT plan to sit within your patient record system, then please contact us at email@example.com. All plans developed will need to be submitted for approval before being adopted for use.
For guidance on the integration of the ReSPECT plan into electronic systems, see our digital top tips.
How do I adopt ReSPECT?
If you are a healthcare organisation wishing to adopt ReSPECT in your locality, please contact firstname.lastname@example.org
People should not expect to use the ReSPECT process until it has been established in their locality.
Phases of ReSPECT adoption:
- As an NHS organisation, you should start by contacting others in your local health and care community to establish whether the ReSPECT process has already been or is in the process of being adopted.
- Once interest in adoption has been established across your trust or ICS you should register your interest. Register your interest by emailing email@example.com
- An Adopter Pack containing all the information and resources you need to adopt ReSPECT will be forwarded to you.
- Complete the Responsibilities Form within the pack and return this by email to firstname.lastname@example.org. Please bear in mind, with your permission that contact details for the Lead clinician and adopter lead as noted on the responsibilities form will be added to the RCUK ReSPECT Adopter network and maybe shared with other ReSPECT Leads. Involvement in the ReSPECT adopter network will ensure any national updates, bulletins or additional resources are shared. Adopter teleconference calls are held three times a year and led by the clinical lead for ReSPECT at RCUK. These provide a platform for sharing updates, resources, experiences, issues and developments.
- The ReSPECT plan will then be sent to you (including both word document and writeable pdf formats).
- Before the ReSPECT logo can be used you must complete a Permission to Use Logo request to RCUK. If you are developing educational resources please ensure you share these with us before they are released for use. You can send an email to email@example.com to request the plan.
- Confirm proposed timescale for adoption within eight weeks of returning the Signed Responsibilities Form.
- Identify and inform firstname.lastname@example.org of the launch date (once this is confirmed).
- Join the ReSPECT Leads network and attend the ReSPECT Leads teleconference calls
- Agree the audit process internally and the timescale from the launch date to the first audit (6-12 months after launch) and notify email@example.com.
- Set up a Project Team (Identify a Clinical Lead/Project Manager/Project Management Team)
- Set up ReSPECT Stakeholder group/Implementation Team
- Conduct a Training Need Analysis.
- Develop an Education Strategy
- Develop a Communication Strategy around Adoption
- Develop a ReSPECT Policy
- Consider & Develop Electronic Options for the ReSPECT plan(optional)
- Identify approach to Adoption Launch
- Launch-Commence the use of ReSPECT Process
- ReSPECT Stakeholder group continues following adoption:
- To review audit/service evaluation data and develop appropriate action plan.
- To have an overview of how ReSPECT is working across the ICS.
- To monitor and review incidence/complaints around ReSPECT
The “How-to-guide” provides more information on the step-by-step guide on the ReSPECT Adoption process.
As an Adopter Lead, you are expected to provide a regular monthly update on the progress of the Adoption implementation to firstname.lastname@example.org using the Highlight report template.
The ReSPECT Learning Web-application is no longer available due to technical limitations with the platform. While we work on developing a replacement, please use the ReSPECT Modules (Awareness and Authorship Trainings) on E-learning for Health. You will need to register and then log in to have access. If you have any questions about access, please reach out to the team at E-learning for Health via https://support.e-lfh.org.uk/.
We hold regular ReSPECT Lead tele-conference calls, which adopter organisations are able to join.
Each region is also expected to have a regional Lead, which may either be a Project Manager and/or a Clinical Lead.
The Regional ReSPECT Lead will work closely with Resuscitation Council UK (RCUK), both during the implementation phase and following adoption of the ReSPECT process.
The Regional ReSPECT Lead role guide is a document outlining the responsibilities of the Regional ReSPECT Lead and their relationship with RCUK.
If you wish to be invited to join the calls, please send an email, advising of which adopter site you work in, to email@example.com
Find supporting files for health care professionals, patients and carers, as well as clinical research publications and newsletter archives in our resource section.
For more information, please visit our frequently asked questions (FAQs) page.