A report by The Queen’s Nursing Institute reveals that the NHS had told 1 in 10 care homes to alter resuscitation orders for elderly and disabled residents behind their back. No consultation with the care home staff, the residents family or the residents themselves had ever taken place.
The reason given was to free up hospital beds that were predicted to be full during the hight of the pandemic; however, this never occurred. Half of the staff asked to alter records worked in care homes for people with cognitive disabilities, while the other half worked in care homes for the elderly.
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Professor Leary, who conducted the report, said: “I was quite surprised how many people reported issues with DNRs as I was expecting one or two, but that 10 percent of the respondents raised an issue because they were either blanket decisions for whole populations, or they were imposed without discussion with the care home or the family or the residents, and that is really worrying.
“These decisions were being made by NHS managers, not clinicians. And this wasn’t just happening with elderly people, it was those with learning disabilities or cognitive problems of all ages.”
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Critics have pointed out that this was a calculated, top-down decision and that the official reason, to free up NHS beds of patients unlikely to survive, does not explain why homes for the cognitively disabled but otherwise healthy were also advised to apply DNR (‘Do Not Rescuscitate’) to their residents’ records. An autistic care provider reported back in April that they had been pressured to do just that – even when there is no greater rate of mortality for autistic adults.
Since 2014, it has been compulsory for doctors to discuss applying a DNR notice to patients’ records, which means this could constitute a violation of medical ethics – not least a legal case.
