CQC publishes its review of DNACPR decisions during COVID-19

The CQC has today published its review and recommendations following the special review it conducted into concerns that ‘do not attempt cardiopulmonary resuscitation’ (DNACPR) decisions were being applied to groups of people, rather than taking into account each person’s individual circumstances during the COVID- 19 pandemic.

Concerns included that that DNACPR decisions were being made without involving people, or their families and/or carers if so wished, and were being applied in a “blanket” fashion.

In October 2020, the Department for Health and Social Care commissioned CQC to conduct a special review into these concerns.

CQC looked at the experiences of over 750 people and spoke with health and care professionals. CQC found some good practice, and did not find there had been a national blanket approach to DNAPCR. However, they found that there was undoubtedly confusion and inconsistency in relation to DNACPR decisions particularly at the outset of the pandemic. They concluded that this risks undermining public trust and confidence in the health and care system and demonstrates the need for better oversight of DNACPR decisions. CQC has a number of detailed recommendations as a result.

CQC found that there needs to be a focus on three key areas:

  • Information, training and support;
  • A consistent national approach to advance care planning; and
  • Improved oversight and assurance.

The full conclusions and recommendations can be read here.

As a result, CQC will undoubtedly continue to seek assurance though inspection and perhaps other means, that people are at the centre of personalised, high-quality and safe experiences of DNACPR decisions, in a way that protects their human rights. Care providers must therefore make sure that their DNACPR processes are implemented in this manner and that the appropriate considerations and consultation is fully documented in care records.


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