Use of ‘do not resuscitate’ orders to be reviewed

The Care Quality Commission (CQC) has been asked by the government to review how ‘do not resuscitate’ orders were used in care homes during the early stages of the pandemic.

The review follows reports earlier this year that elderly and vulnerable people may have been subjected to DNACPR (Do Not Attempt Cardiopulmonary Resuscitation) without their consent or with little information to allow them to make an informed decision.

In April, the watchdog published a joint statement with the British Medical Association (BMA) Care Provider Alliance (CPA) and Royal College of General Practitioners (RCGP), reminding all providers that it was unacceptable for advance care plans, with or without DNAR form completion to be applied to groups of people of any description.

The CQC said the interim findings of the review are expected to be reported later this year, with a final report in early 2021.

‘We welcome this commission from Department of Health and Social Care and are taking it forward at pace,’ said the CQC’s chief inspector of primary medical services and integrated care, Dr Rosie Benneyworth.

‘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,’ added Dr Benneyworth.

‘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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