The CQC will investigate the use of blanket ‘do-not-resuscitate’ orders in care homes, primary care and hospitals.
This follows concerns that elderly and vulnerable people were subject to Do-Not-Attempt-Cardiopulmonary-Resuscitation (DNACPR) decisions without their consent or informed choice earlier on in the Covid-19 pandemic.
CQC chief inspector of primary medical services and integrated care Dr Rosie Benneyworth said it is ‘unacceptable’ for do-not-resuscitate decisions to be applied to a group of people and that they ‘must continue to be made on an individual basis’.
She continued: ‘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.’
Both staff and patients’ families had raised concerns about care to the CQC, she added.
The review will look to identify and share best practice around DNACPR and identify where decisions may not have been patient-centred.
Interim findings are expected to be reported later this year with a final report in early 2021.
Director of research and influencing at Alzheimer’s Society Fiona Carragher said: ‘Let’s be clear – it’s appalling to hear that a blanket DNAR approach was ever taken, effectively denying people their right to life, without permission appropriately obtained.
‘It’s vital that the CQC investigation ensures this never happens again, correcting any cases where it may have been inappropriately applied.’
DNACPR orders can allow individuals to make a shared decision about what intervention they would like if they suffer cardiac or respiratory arrest, including refusing resuscitation.
Any advanced care plan and decision should always be made with the individual or, if they lack the capacity to engage, family members or other appropriate individuals, NHS England says.
In April, the CQC published a joint statement with the British Medical Association, the Care Provider Allowance and the Royal College of General Practitioners, which said it was unacceptable for advanced care plans to be applied to groups of people.