Pressures on care homes may have led to the decision to use do not attempt cardiopulmonary resuscitation (DNACPR) (do not resuscitate) orders without patient consent at the start of the Coronavirus pandemic.
This is one of the main early findings of the CQC’s interim report on the review of DNACPR that it is currently undertaking.
The CQC noted that guidance intended to help clinicians assess frailty as part of a wider, holistic assessment around the appropriateness of critical care may have been interpreted as the sole basis for clinical decisions in some instances.
The misinterpretation was quickly acknowledged, and revised guidance was issued five days later, to make it clear that this was not an appropriate use of the frailty scale.
DR UK Head of Policy Fazilet Hadi said: “An urgent, root and branch investigation of every DNACPR order currently in place is needed to ensure that there is not a single case of an unrequested DNACPR order left in place from the Spring.
“The blanket application of these orders at the start of the pandemic felt akin to genocide by stealth of disabled people.
“That assessment of us as being ‘too frail’ could lead to the decision as to whether we live or die being imposed upon us, shows that there is a fundamental systemic lack of respect and equality of the lives of disabled people.
“It is inconceivable that such orders would be placed, en masse, on the medical records of non-disabled people, and yet there we were.
“We welcome the CQC’s efforts to date in investigating this horrific, sorry subject.”
Read the press release here: https://www.cqc.org.uk/news/releases/cqc-finds-combination-increasing-pressures-rapidly-developing-guidance-may-have
Read the report here: https://www.cqc.org.uk/publications/themed-work/review-do-not-attempt-cardiopulmonary-resuscitation-decisions-during-covid
The CQC is also asking groups that want to work with it on this issue to contact it here: https://cqc.citizenlab.co/en-GB/projects/dnacpr-review-during-the-covid-19-pandemic