Urgent action needed over ‘do not resuscitate’ breaches

More than 500 people may have had their human rights breached over ‘do not resuscitate’ decisions made during the coronavirus pandemic, it has been revealed.

The Care Quality Commission (CQC) has called for ministerial action to tackle the “worrying variation” in people’s experiences of ‘do not attempt cardiopulmonary resuscitation’ (DNACPR) decisions.

Some families, it says, were not properly involved and others totally unaware decisions had been made.

A combination of “unprecedented pressure” on providers and “rapidly developing guidance” may have led to situations where DNACPR decisions were incorrectly conflated with other clinical assessments, the care regulator has claimed.

Care home providers told the watchdog there were a total of 508 do not attempt cardiopulmonary resuscitation (DNACPR) decisions that had been put in place after 17 March last year without any discussion with the patient or their family. The CQC said a third, 180, of these orders were still in place in December.

The CQC was asked by the Department of Health and Social Care to conduct a rapid review of how DNACPR decisions were used at the start of the coronavirus pandemic.

It followed concerns decisions were being made without the involvement of patients or relatives, and that they were being applied in a blanket way to particular groups, for example people with learning disabilities.

The CQC said it heard evidence from “people, their families and carers that there had been blanket DNACPR decisions in place”. It was told by 119 care home providers that people in their care had been “subject to blanket DNACPR decisions” since March last year.

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