Blanket DNR orders for people with learning disabilities ‘unacceptable’, says NHS England


NHS England has issued a reminder to primary and secondary care staff that do not attempt cardiopulmonary resuscitation (DNACPR) notices should never be placed on a person’s record “just because” they have a learning disability, autism or both.

In a letter to CCGs and GPs, it said blanket policies are “inappropriate”, whether due to a medical condition, disability or age.

NHS England said this particularly important in regard to DNACPR orders, which “should only ever be made on an individual basis” and in consultation with the individual or family.

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The reminder comes a year after the CQC issued a joint statement with British Medical Association, Care Provider Alliance, Care Quality Commission and the Royal College of General Practitioners, condemning GPs across the country for categorising people who receive care in community settings as not requiring resuscitation if they fall ill with coronavirus.

During the coronavirus pandemic repeated examples of unlawful decisions have emerged including widespread blanket orders on care home residents and patients with learning disabilities.

Voyage Care, which supports people with learning disabilities, autism, brain injuries and other complex needs, reported in April 2020 that three of its services in Somerset, Derbyshire and East Sussex were contacted by GPs to recommend that all of their clients should not be resuscitated if they contract the virus.

Condemning this practice, NHS England said: “The NHS is clear that people should not have a DNACPR on their record just because they have a learning disability, autism or both. This is unacceptable.

“The terms ‘learning disability’ and ‘Down’s syndrome’ should never be a reason for issuing a DNACPR order or be used to describe the underlying, or only, cause of death. Learning disabilities are not fatal conditions. Every person has individual needs and preferences which must be taken account of and they should always get good standards and quality of care.”

Sarah Clarke

The author Sarah Clarke

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