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Government to tackle inappropriate ‘do not attempt CPR’ orders for people with learning disabilities

Department of Health and Social Care's review of service inequalities is in response to 2019’s critical Learning Disabilities Mortality Review report 

Department of Health and Social Care's review of service inequalities is in response to 2019’s critical Learning Disabilities Mortality Review report    

The government says that it will tackle inappropriate ‘do not attempt cardiopulmonary resuscitation’ (DNACPR) orders for people with learning disabilities.

The plans are part of the Department of Health and Social Care’s (DHSC) official response to the third Learning Disabilities Mortality Review (LeDeR) report.

Care of almost one in ten adults with learning disabilities was well below what should be expected

Published in May 2019, the LeDeR report found 19 people had ‘learning disabilities’ or ‘Down’s syndrome’ recorded as a reason for DNACPR orders.

In the DHSC's official response, published on 12 February, it has asked the Care Quality Commission to identify and review DNACPR orders and Treatment Escalation Personal Plans relating to people with learning disabilities at inspection visits by October.

The LeDeR report also revealed that around 250 people had their cause of death described as Down’s syndrome and that the care of almost one in ten adults with learning disabilities was well below what should be expected and, in some cases, had contributed to their death.

‘Learning disabilities are not fatal conditions’

In response to these findings, a DHSC spokesperson commented: ‘Learning disabilities are not fatal conditions and should never be used as a cause of death.’

The DHSC response also states that by the end of 2020, NHS England expects every clinical commissioning group to be able to conduct mortality reviews within six months, apart from where other investigatory processes mean a longer interval is appropriate.

This is in response to the LeDeR report highlighting the need for mortality reviews of people with learning disabilities to be completed in a timely manner, with over 2,700 still in progress at the time of the report’s publication.

The DHSC also repeated its commitment to develop mandatory learning disability and autism training for different health and social care settings in 2020-21.


Oliver McGown

Mandatory learning disability nursing training named in memory of Oliver McGowan

Initially announced last year, the training will be named in memory of Oliver McGowan, who had high functioning autism, epilepsy and learning disabilities.

The 18-year-old died at Southmead hospital in Bristol in 2016 after being given a drug he was allergic to, despite repeated warnings from his parents.

The charity Skills for Care is to publish a skills and training audit of the social care workforce later this year, which will inform the development of the mandatory training programme.

A Learning Disability England spokesperson said: ‘The government’s response includes some positive moves towards what is needed, but transparency, leadership and action must be prioritised to end inequality now.’


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