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COVID and DNR Anguish

Concerns that DNR used inappropriately in care homes.

It is reported today that during the first wave of the Coronavirus pandemic, Care Homes may have been given inappropriate guidance in the use of Do Not Resuscitate orders.

This information has come to light following an investigation undertaken by the Care Quality Commission (CQC) and relates to the use of those orders which confirm that certain patients should not receive cardiopulmonary resuscitation.  As a result of the investigation it was found that complaints relating to these types of orders had increased massively during the first wave of the pandemic, March through to September 2020 when compared to the previous six months.

It is not clear, yet, why this happened but it is clearly something of concern to the CQC.

What is a DNACPR?

A DNACPR decision is made and recorded to guide the decisions and actions of those present should the person suffer cardiac arrest.

What is the position of the CQC?

It is important to know, though, that CQC guidelines are clear in that failing to offer all options to patients and their families is a breach of their human rights, and that “blanket” decisions must never be made.

Consideration, of course, has to be given to those patients who may lack capacity to consent.

The message has to be that the NHS have been under immense pressure and the care provided by them and their colleagues working in Care Homes has been nothing short of “heroic” but the question is was there little or no support for them? 

Were they properly trained in the need for these, how to discuss with the patients’ family?  Taking that point further questions whether then, the use of the DNACPR was appropriate?

Final outcomes from the CQC are awaited.

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