Editorial

DNACPR notices: learning disability nurses are best-placed advocates for families

CQC report acknowledges vulnerabilities of service users during COVID-19

Care Quality Commission report on resuscitation notices acknowledges the vulnerabilities of service users during COVID-19

The Care Quality Commissions report on do not attempt cardiopulmonary resuscitation decisions (DNACPR) has made some recommendations on advanced planning and end of life care.

The report comes in response to concerns that people with learning disabilities and their families were not being consulted by some clinicians early in the COVID-19 pandemic and that blanket DNACPR decisions could be in place.

Do not resuscitate decision should be person-centred, says CQC

Care Quality Commission report on resuscitation notices acknowledges the vulnerabilities of service users during COVID-19

Care Quality Commission report on resuscitation notices acknowledges the vulnerabilities of service users during COVID-19
Picture: iStock

The Care Quality Commission’s report on do not attempt cardiopulmonary resuscitation decisions (DNACPR) has made some recommendations on advanced planning and end of life care.

The report comes in response to concerns that people with learning disabilities and their families were not being consulted by some clinicians early in the COVID-19 pandemic and that ‘blanket’ DNACPR decisions could be in place.

Do not resuscitate decision should be person-centred, says CQC

Recommendations from the report, which was commissioned by England’s Department of Health and Social Care, include more education and support, including that every DNACPR decision should be person-centred encompassing each person’s situation and wishes.

The report also recommends that there should be a ‘consistent national approach’ to advanced care planning and improved oversight including ‘comprehensive’ records of conversations and decisions with individuals, families and carers.

It is the kind of involvement that learning disability nurses can and do excel in whether you are a liaison nurse or not.

Outcry when people with learning disabilities not identified as a priority group for COVID-19 vaccine

It’s been widely reported that COVID-19 has further exposed health inequalities that have always existed and this is certainly true for the care of people with learning disabilities.

When people with learning disabilities generally were not identified as a priority group for the COVID-19 vaccine there was an outcry.

Pressure from nurses, families and learning disability charities

That decision was eventually overturned after pressure on many fronts including nurses, charities and the DJ Jo Whiley whose sister has a learning disability. This decision opened up the opportunity for all those with learning disabilities and not just those with profound and multiple learning disabilities or Down’s syndrome to be prioritised.

The CQC says it heard from more than 750 people about not being involved in decisions about their care. And, as the report states: ‘When done well, DNACPR decisions are an important aspect of advance care planning, and people should be fully involved in discussions about their care.’

Find out more

Care Quality Commission (2021) Protect, Respect, Connect – Decisions About Living and Dying Well During COVID-19


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