CQC condemns GPs over ‘do not resuscitate’ notices on care plans

The Care Quality Commission has condemned GPs across the country for categorising people who receive care in community settings as not requiring resuscitation if they fall ill with coronavirus.

The regulator made a statement after service users, including disabled adults of working age, had ‘do not attempt resuscitation’ (DNAR) notices applied to their care plans during the coronavirus pandemic without consultation with them or their families.

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

CEO Andrew Cannon said on Twitter that the decisions were made with “no consultation with families”, adding “we will fight this”.

Speaking to Home Care Insight, he said: “The people we support are our priority and we are working with the relevant authorities to ensure their rights are met.”

Elsewhere, people living in care homes in Hove, East Sussex and South Wales have also DNAR notices applied to their care plans, according to the Guardian.

And an NHS health board in another area of Wales has apologised after a GP surgery near Port Talbot recommended that patients with serious illnesses complete DNAR forms.

In a joint statement with the British Medical Journal, the Care Provider Alliance and the Royal College of General Practice, the CQC said it is “unacceptable” for advance care plans, with or without 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,” it said.

The statement continued: “The importance of having a personalised care plan in place, especially for older people, people who are frail or have other serious conditions has never been more important than it is now during the Covid 19 Pandemic.

“Where a person has capacity, as defined by the Mental Capacity Act, this advance care plan should always be discussed with them directly. Where a person lacks the capacity to engage with this process then it is reasonable to produce such a plan following best interest guidelines with the involvement of family members or other appropriate individuals.

“Such advance care plans may result in the consideration and completion of a Do Not Attempt Resuscitation (DNAR) or ReSPECT form. It remains essential that these decisions are made on an individual basis.”