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ReSPECT Process

What is the ReSPECT process?

Emergency care and treatment plans (ECTPs) record a summary of decisions made as a result of discussions between patients and their doctors or nurses about the kind of treatments and care they want in the case of an emergency. A national working group made up of patient representatives, health professionals, and organisations has developed new Emergency Care Treatment Plan documents known as the ReSPECT process (Recommended Summary Plan for Emergency Care and Treatment).

Why is the ReSPECT process needed?

The ReSPECT process will replace a system where only one aspect of emergency treatment is considered - when a person's heart stops beating (cardiac arrest). This system only concerns the decision of whether or not a treatment called cardiopulmonary resuscitation (CPR) should be attempted to help restart the heartbeat. When it is felt CPR would not work or would be more likely to cause harm than provide benefit a decision, known as a Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) is recorded on the form. Therefore, the ReSPECT process integrates DNACPR decisions within an overall emergency treatment plan which includes treatments the patient would or would not want in an emergency situation.

Previous work has identified that CPR is still performed on several occasions where there is little or no chances of success, impacting on the quality of care a patient is receiving. Decisions about CPR are undertaken hundreds of times each day in NHS hospitals; therefore, it is important to ensure the correct decisions are being made. Misinterpreting a DNACPR decision or inappropriately withholding CPR treatment when it could work will cause harm and could cost lives. There has also been a reluctance or fear in both patients and doctors to discuss CPR which has led to failure to involve the patient in the decision-making. This has led to patient wishes not being carried out in an emergency setting as a result of poor communication and hesitation to initiate ethically challenging conversations. The ReSPECT process aims to increase communication between doctors and patients by encouraging conversation's about the patient's priorities for care alongside agreed clinical recommendations.

The ReSPECT process and the evaluation

This study is not responsible for the development or implementation of the ReSPECT process within NHS trusts. It's purpose is to evaluate ReSPECT as a new process in the NHS. The evaluation is important in establishing how well the ReSPECT process works, whether it needs revision and to understand its impact on patient care.

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For general enquiries, please contact
Claire Jacques (Trial Manager)