Decisions on resuscitation
An update to NHS Scotland policy.
Work to update the NHS Scotland policies for CPR towards the end of life is nearing completion.
In 2010 Scotland became the first country in Europe to implement a national policy to support best practice in CPR decision making and communication. A recent legal ruling and associated changes in UK-wide good practice guidance have prompted a light touch review of Scotland's policies for adults and for young adults and children. The review has been informed by clinician, patient and carer experience.
The updated policies and associated documents are being circulated for feedback from healthcare professionals and patient groups before being finalised.
The policies continue to support consistency and transparency in decision-making. The update emphasises the importance of engaging with patients and their families about CPR decision-making in the context of the goals of care, treatment options and choices. Sometimes CPR will not help and will only cause harm and distress for the patient and their family. Where CPR might offer a possible benefit there are some patients who wish to make it clear in advance that they would not want CPR to be attempted.
The Scottish Government is also working with NHS Education Scotland (NES) to ensure that staff have access to updated training resources.
The engagement process will run until the end of August with the updated policies due to be published around September 2015.
Health Secretary Shona Robison said:
“This review and update of Scottish policies is part of our efforts to ensure that palliative and end of life care is delivered to a high standard, in every situation, right around the country. Everyone, child, young person or adult has the right to a dignified death.
“Whether or not to attempt CPR towards the end of someone’s life is one of the most emotive and sensitive decisions that patients, doctors and relatives will ever have to face.
“There are occasions when CPR is attempted inappropriately against the patient’s wishes or when the patient is in the very final stages of their illness and it is clear that CPR will not work. That can be distressing for everyone involved, and it’s why it’s so important that a conversation takes place.
“Proper training for clinical staff is vital, and we’re working to ensure that this is in place. Conversations about CPR need to happen as part of establishing patients’ goals of care, treatment options and wishes for end of life care. What is important is that treatment options are discussed honestly and that the patient’s wishes are taken into account where possible. The option of a dignified death must be open to everyone in all circumstances.”
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