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The Care Quality Commission’s (CQC) review and interim report into the application of Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) orders during the Covid-19 pandemic reveals evidence of unacceptable and inappropriate DNACPR orders being made at the start of the pandemic, possibly as a result of confusion, miscommunication and providers being overwhelmed. It is also the case that some of these orders may still incorrectly be in place.
Clearly, DNACPR orders should not be applied to groups of vulnerable people against their wishes. The reasons behind why they are applied may vary, but what should remain consistent is that they are applied properly, on an individual basis.
Best practice guidelines have been set out by the Resuscitation Council UK, but the findings of the CQC’s review shows that they aren’t being followed everywhere. The CQC is now undertaking the next stage of its review, namely fieldwork in seven Clinical Commissioning Groups in order to better understand how DNAR orders have been used since the start of the pandemic, what good practice looks like, and identifying what local systems need to do in order to guard against future errors. The final report is expected in February 2021.
There is clearly a need for all of us to initiate our own conversations about whether we would want CPR, and also about our wider care wishes. Once we’re in an emergency situation it’s often too late. Only 59% of those aged 70+ have talked to loved ones about their care wishes. Whilst 81% of us think planning ahead for later life is important, only 22% of us have a Lasting Power of Attorney in place, setting out our wishes in writing, in a legally binding way.
As a country, we need to start talking about our wishes should we lose mental and/or physical capacity or require emergency medical treatment. This recent investigation into the use of DNACPR orders should encourage us all to have those difficult, but vital conversations, no matter our age.
If you would like any advice in relation to Lasting Powers of Attorney then please contact Gemma Shepherd who is an Associate Solicitor at Michelmores LLP in Sidmouth (Tel: 01395 512515) and member of SFE (Solicitors for the Elderly), the membership organisation for specialist solicitors who support older and vulnerable people.