More than 500 people in the UK ‘did not resuscitate’ without their consent or their caregivers’ consent during the coronavirus pandemic, a study released by the country’s Care Quality Commission (CQC) reported on Thursday.
From the beginning of the COVID-19 pandemic, there have been concerns that ‘no cardiopulmonary resuscitation (DNACPR) decisions should be taken without involving people, or their families and / or carers, and if applied to groups’. word. of people, rather than taking into account each person’s individual circumstances, ”according to the study by the independent regulator of health and social care in England.
Out of 2048 adult social care providers who responded to the CQC’s request for information, 5.2% (508 out of 9,679) of the DNACPR decisions implemented since 17 March 2020 were not with the person, their family member or caregiver did not agree, ”said the study.
The report contains at least one case study of a man whose death may have had an involuntary order not to resuscitate.
‘Jim, who was in the’ 80s, was taken to a hospital at the start of the pandemic after he became ill with a breast infection. “Jim, who was still working, was normally fit, well and active and went out in his car most weeks to visit friends or go to the theater,” the report reads.
‘About 12 hours after he was admitted to hospital, Jim called [his daughter] Melanie. He was upset and confused and told her that he had signed off on his life and was going to die. He told her that a doctor had issued an order that they would not start his heart again if it stopped. He was upset because he agreed to it because he did not want to die. ”
The daughter told the commission she was trying to talk to medical and nursing staff about the decision.
“Because Jim was able to make decisions about his care, no one discussed the decision with her,” she said, according to the report. ‘However, she was worried that her father was vulnerable because he was ill, would probably be confused because he had a bad infection, and that he was alone. She felt that he would just go along with what they told him. ‘
“Jim died at the hospital,” the report said.
The report is a result of a request from the Department of Health and Social Care to the CQC to build a “quick review of how DNACPR decisions were used during the coronavirus pandemic on concerns that it is being applied inappropriately” on groups of people without their knowledge. ”
“It is unacceptable that DNACPR decisions are made without proper consultation with the individual, or a suitable representative, taking into account their wishes and needs,” the report states.
‘An interim report by the CQC in November 2020 reveals’ a combination of unprecedented pressure on healthcare providers and rapidly evolving guidance could have led to decisions on DNACPR being misconnected with other clinical assessments around critical care, ” CQC said.
Despite positive feedback from most care providers, CQC has expressed concern about the use of DNCPR decisions proposed at the local level.
“In the course of the review process, although inspectors found examples of good practice, they also found a worrying picture of the poor involvement of people using services, poor record keeping and a lack of oversight and scrutiny of the decisions taken. be, “the study said. said.
The CQC called on government action to address a ‘worrying variation’ in people’s experiences of DNACPR decisions and ‘to take responsibility for improving this important and sensitive area.’
The CQC’s aim with the plea to ministers is to have a greater focus on ‘information, training and support’, as well as a ‘consistent national approach to care planning’ and ‘improved supervision and insurance’, he said.
Correction: An earlier version of this article incorrectly stated the date on which the CQC’s interim report was released.