Coronavirus

Health regulators to investigate do not resuscitate orders

Health regulators have been asked to step in to review how care homes approach do not attempt resuscitation orders, it has been confirmed.

The Department of Health and Social Care has asked the Care Quality Commission (CQC) to investigate concerns that do not attempt resuscitation (DNAR) orders were being enforced without permission during the pandemic.

In April, the CQC published a statement with the British Medical Association (BMA) Care Provider Alliance (CPA) and the Royal College of General Practitioners (RCGP), reminding all care providers that advance care plans must always be agreed.

Compassion In Dying is a charity that supports and prepares people for the end of their life.

The organisation has been calling for an inquiry into the use of DNAR orders during the pandemic.

Speaking to the Mail Online, Usha Grieve, director of partnerships and information at the charity, said: “Coronavirus has highlighted and exacerbated ongoing problems with decision-making and communication around DNRs, which have proliferated under a lack of clear, national guidance.

“This has had devastating effects on patients and families right across the spectrum – from DNRs being issued in a blanket way, to decisions not being properly communicated or explained to patients or families, to people who want to protect themselves from potentially harmful or futile CPR feeling ignored.”

Dr Rosie Benneyworth, Chief Inspector of Primary Medical Services and Integrated Care at the Care Quality Commission, said: “We welcome this commission from Department of Health and Social Care and are taking it forward at pace. This builds on the concerns we reported earlier in the year and we are pleased that they are being given closer attention.

“Health and social care providers have faced extraordinary pressures this year. Both staff, and people using services and their loved ones, have at times raised concerns with us about care. It is vital that we take this opportunity to learn from what has happened – challenging poor care and sharing the ways that providers have put people’s needs at the heart of their care so that others can learn from them.

In the community:

“Along with partners we have been clear that it is unacceptable for advance care plans, with or without Do Not Attempt Resuscitation (DNAR) form completion, to be applied to groups of people of any description. These decisions must continue to be made on an individual basis according to need.

“Through this review we will look to identify and share best practice in this complex area, as well as identifying where decisions may not have been patient-centred and ensuring mistakes are not repeated.”

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