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The process used to discuss and document an individual’s emergency care wishes has been altered in order to make it more “patient-centred” and reduce the likelihood of “misunderstandings”.
The changes follow concerns raised during the coronavirus pandemic about the way decisions were being made about whether to perform cardiopulmonary resuscitation (CPR) on a patient.
“The new form will support better conversations and well-informed decision-making in advance”
The Resuscitation Council UK’s ReSPECT (Recommended Summary Plan for Emergency Care and Treatment) system is used across most of England and some parts of Scotland.
The ReSPECT form allows patients to record their clinical care wishes in the event of an emergency such as a cardiac arrest including whether CPR should be attempted.
Once completed, the form stays with the patient and should be immediately available to any health or care professional called to help in an emergency, whether in the community or in a clinical setting.
Updates have been made by the Resuscitation Council UK following feedback from professionals, patients and families, and will be implemented into clinical practice from today.
Under the changes, the form is now better designed to record what the individual values most, what they fear most and what they wish to avoid, according to the council.
The changes also mean clinicians and patients have more options beyond choosing between either prioritising sustaining life or prioritising comfort.
In addition, a prompt how now also been embedded into the process to ensure that when decisions are made without involving the patient, the reasons for this are clearly documented.
There is also a reminder that if the person lacks capacity a ReSPECT conversation must take place with the family or another person with legal authority to represent that individual, known as a “legal proxy”.
The patient or their legal proxy or family member can also now sign the document to reflect that they had been actively involved in the discussion and recommendations given about future treatment.
According to the Resuscitation Council UK, the updates made have created a more patient-centred form, with increased prompts for explicit clinical reasoning.
“It is crucial to have a person-centred approach and conversations”
Dr Zoe Fritz
It said it addressed areas where misunderstandings had previously been reported and included more personable and clearer language.
Sue Hampshire, director of clinical and service development at Resuscitation Council UK, said the council was “pleased to be introducing updated documentation to underpin the ReSPECT process today”.
“People have different views about the care or treatments they would want if they were suddenly ill and could not make decisions about their care or treatment,” she added.
“The new form will support better conversations and well-informed decision-making in advance, and we are happy to be introducing it for professionals and patients.”
Meanwhile, Dr Zoe Fritz, chair of the ReSPECT subcommittee, said: “A number of misconceptions exist about CPR and when and how recommendations not to attempt CPR are made.
“So, it is crucial to have a person-centred approach and conversations that aim to ensure shared understanding between the professional and patient.
“By doing so, any misunderstandings can be addressed, and professionals can ensure that any recommendations made are based on what’s important to the patient.”