CQC to review use of ‘do not resuscitate’ orders during pandemic

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The Care Quality Commission (CQC) will review how do not attempt resuscitation (DNAR) decisions were made during the COVID-19 pandemic.

Following a request by the Department of Health and Social Care, the regulator is expected to look at people’s experiences in care homes, primary care and hospitals.

Earlier this year concerns were reported that elderly and vulnerable people were being subjected to DNAR decisions without their consent or with little information to allow them to make an informed decision.

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

Voyage Care, which supports people with learning disabilities, autism, brain injuries and other complex needs, reported at the time 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.

Interim findings from the report are expected to be published later this year with a final report in early 2021.

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.

“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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Sarah Clarke

The author Sarah Clarke

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