Do Not Resuscitate orders given inappropriately in first lockdown, care home provider report finds

Orders not to resuscitate have been imposed inappropriately on patients on some occasions during the pandemic, a new report has said.

The Care Quality Commission (CQC) has said that some providers may have proposed “blanket” DNRs to certain groups during the pandemic, or made orders on people without their or their families’ knowledge. Photo: Adobe

Do Not Attempt CPR orders (DNRs) are made by medics if it is decided that the trauma of CPR would be more detrimental to a patient than to allow them to die if their heart stops.

The Care Quality Commission (CQC) has said that some providers may have proposed “blanket” DNRs to certain groups during the pandemic, or made orders on people without their or their families’ knowledge.

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Care providers said more DNRs were made in the first wave of the pandemic.

On March 16, 2020, 28 per cent of people in adult social care settings questioned by the CQC had a DNR in place, which increased to 36 per cent between March 17 and December 2020.

The increase was larger in nursing homes, 74 per cent of patients having a DNR before the pandemic, compared to 92 per cent in the first wave.

No guidance was given to medics that blanket DNRs should be made on any group because of the pandemic, and guidance was issued in the first lockdown by the British Medical Association reminding medics that such decisions were unacceptable.

The CQC has now called for health ministers to review the practice of giving DNR orders.

Rosie Benneyworth, chief inspector of primary medical services at the CQC said: “It is vital we get this right and ensure better end of life care as a whole health and social care system, with health and social care providers, local government and the voluntary sector working together.”

A DHSC spokesperson said: “It is totally unacceptable for ‘Do Not Attempt CPR’ orders to be applied in any kind of blanket fashion – this has never been policy and we have taken decisive action to prevent it from happening, working closely with the health and care sector to make this clear and asking the CQC to undertake this review.”