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Care watchdog to review use of DNACPR during pandemic

The Care Quality Commission is to review how Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions were used during the coronavirus pandemic.

The CQC said the review, commissioned by the Department for Health and Social Care, would build on concerns reported earlier in the year that elderly and vulnerable people might be being subjected to DNACPR decisions without their consent or with little information to allow them to make an informed decision.

The scope and methodology of this work are being developed “at pace”, the watchdog said, but it is expected to look at people’s experiences in care homes, primary care and hospitals.

In April, the CQC published a joint statement with the British Medical Association (BMA) Care Provider Alliance (CPA) and Royal College of General Practitioners (RCGP), reminding all providers that it is unacceptable for advance care plans, with or without DNAR form completion to be applied to groups of people of any description.

Interim findings are expected to be reported later this year with a final report in early 2021.

Dr Rosie Benneyworth, Chief Inspector of Primary Medical Services and Integrated Care at the Care Quality Commission, said: "Health and social care providers have faced extraordinary pressures this year. Both staff, and people using services and their loved ones, have at times raised concerns with us about care. It is vital that we take this opportunity to learn from what has happened – challenging poor care and sharing the ways that providers have put people’s needs at the heart of their care so that others can learn from them.

"Along with partners we have been clear that it is unacceptable for advance care plans, with or without Do Not Attempt Resuscitation (DNAR) form completion, to be applied to groups of people of any description. These decisions must continue to be made on an individual basis according to need. Through this review we will look to identify and share best practice in this complex area, as well as identifying where decisions may not have been patient-centred and ensuring mistakes are not repeated."

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