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COVID-19: warning against 'blanket' DNACPR notices

NMC and General Medical Council say advance care plans, which can include DNACPR notices, must be person-centred


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Concerns over misuse of advance care plans – including ‘do not attempt cardiopulmonary resuscitation’ (DNACPR) notices – have led nursing and medical regulators to issue a joint warning to registrants to ensure person-centred care continues during the COVID-19 pandemic.

'Thoughtful and compassionate handling' of advance care plans

In the new statement, the Nursing and Midwifery Council (NMC) and the General Medical Council (GMC) say they are aware of recent instances when advance care plans – which can include DNACPRs – have been applied to groups of people.

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There needs to be 'thoughtful and compassionate handling' of discussions about putting in place a DNACPR or a recommended summary plan for emergency care and treatment (ReSPECT care plan), it states.

NMC chief executive Andrea Sutcliffe said: ‘In recent weeks I have been disturbed by reports of blanket DNACPR orders being applied to groups of people without their involvement or any individual assessment of their needs. This is completely unacceptable.

'We know the best care is person-centred and tailored to people’s individual needs.’

Person-centred care must be maintained amid rapid decision-making

Ms Sutcliffe acknowledged that healthcare professionals were currently ‘making rapid decisions in very complex situations’.

‘That’s why it is so important for health and care professionals to work together with the people they are caring for, and those close to them, to understand their wishes and preferences when it comes to plans for their care.

‘I am confident that, handled with the skill and compassion our nursing and midwifery professionals show every day, those conversations will mean the rights and wishes of people using health and care services are understood, respected and honoured.’

Speaking at a Downing Street press briefing on Wednesday evening, health and social care secretary Matt Hancock said the government was making it 'crystal clear' that it was unacceptable for advanced care plans - DNACPR notices - to be applied in a blanket fashion to any group of people.

'This must always be a personalised process, as it always has been,' he said.


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