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DNACPR notices: review finds ‘unacceptable and inappropriate’ use early in pandemic

Care Quality Commission says older and vulnerable people most at risk

Care Quality Commission says older and vulnerable people may have had decisions made without their consent

Image of an older person's hands with a 'Do not resusciate' notice placed on their wrist
Picture: iStock

‘Unacceptable and inappropriate’ do not attempt cardiopulmonary resuscitation (DNACPR) notices were made at the start of the COVID-19 pandemic, a Care Quality Commission (CQC) interim review has found.

The findings come after the CQC raised concerns that older and vulnerable people may have had DNACPR decisions made without their consent, or may have made them without enough details for an informed decision.

Care providers should ensure notices follow legal requirements

The interim review, which covered care homes, primary care and hospital settings, also found that in some cases inappropriate DNACPR notices remain in place.

The CQC has called for all care providers to ensure that these notices meet legal requirements.

Nursing and Midwifery Council chief executive Andrea Sutcliffe
NMC chief executive Andrea Sutcliffe

Commenting on the interim report, Nursing and Midwifery Council (NMC) chief executive Andrea Sutcliffe said: ‘It’s horrifying to hear of DNACPR notices being applied to anyone without their involvement, consent and their individual needs being taken into account.’

Ms Sutcliffe added that professionals on the NMC register must practice in line with The Code and follow principles of person-centred and individualised care.

Nurses’ responsibility to ‘do right thing and act on their concerns’

‘Everyone working across health and care has a responsibility to support nurses, midwives and nursing associates to do the right thing, and to listen and act on their concerns if they speak up about inappropriate decisions being made,’ she said.

The CQC’s full review will be released in February 2021. Work will continue to review the experience of older people and people with a learning disability and/or autism, who may have been disproportionately affected by this issue.

CQC chief inspector of primary medical services and integrated care Rosie Benneyworth said: ‘We have worked quickly to share these interim findings and will build on the evidence to make recommendations for the future.’

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Care Quality Commission interim report


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