Palliative Care: Learning Disability

(asked on 28th April 2020) - View Source

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what mechanisms are in place to monitor the use of Do Not Resuscitate (DNR) orders to ensure that those orders are not wrongfully applied; whether he has held discussions with providers of supported living and residential care for people with learning disabilities on the number of DNR orders issued during the covid-19 outbreak that are open to legal challenge; and if he will make a statement.


Answered by
Helen Whately Portrait
Helen Whately
Minister of State (Department of Health and Social Care)
This question was answered on 19th May 2020

We accept that in some circumstances do no attempt cardiopulmonary resuscitation (DNACPR) decisions can protect patients from invasive treatments that have little or no chance of success and help to ensure that the patient can die with dignity.

However, we are clear that it is completely unacceptable for such decisions to be applied in a blanket fashion to any group of people, or for a DNACPR decision to be put in place without appropriate consultation with the patient concerned, or their families and carers if the patient lacks capacity.

We take this issue very seriously and have taken steps to remind all clinicians of their responsibilities in this regard. On 30 March, the Care Quality Commission, British Medical Association, Care Provider Alliance and Royal College of General Practitioners wrote to adult social care providers and general practitioner practices to set out their shared position on the importance of advance care planning being based on the needs of the individual. This statement is available at the following link:

https://www.cqc.org.uk/news/stories/joint-statement-advance-care-planning.

NHS England and Improvement have also written to the NHS regarding the appropriate use of do not attempt cardio pulmonary resuscitation (DNACPR) decisions for people with learning disabilities and other vulnerable groups. These letters are available at the following links:

https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/04/C0166-Letter-DNACPR.pdf

https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/04/maintaining-standards-quality-of-care-pressurised-circumstances-7-april-2020.pdf

The number of individual DNACPR decisions is not reported centrally. We are working with the social care sector to understand their experiences of the wrongful application of DNACPR decisions and what further action may be needed to address inappropriate practices.

Reticulating Splines