Up to 40,000 families kept in the dark about Do Not Resuscitate orders: Survey finds a fifth are not told when notices are put in place on their loved ones
- Estimated 200,000 patients are issued with DNR orders each year
- Audit of dying patients put in place in bid to reform end of life care
Survey’s chairman said doctors should be open with patients facing death
The same study showed that in 16 per cent of cases there was also no record of doctors informing the patient themselves about the DNR order.
The national audit of dying patients was put in place as part of an attempt to reform end of life care.
The discredited Liverpool Care Pathway, which saw the withdrawal of food, fluid and medication when patients were close to death, was axed in 2014.
Prof Sam Ahmedzai, chairman of the audit and author of recent guidelines on care of the dying, said: ‘When a decision has been taken, it is unforgivable not to have a conversation with the patient – if they are conscious and able – or with the family.’
On average patients were in hospital five days before they were identified a likely to by dying.
Of that number half were dead by the next day.
Prof Ahmedzai said that doctors should be more open with patients facing death.
He told the paper: ‘This is being done very late in the day – as doctors we just don’t like to face up to it.’
The Royal College of Physicians and Royal College of Nursing are also worried that too many staff were ignoring distress, pain and failing to alert them to life-or-death decisions
Amanda Cheesley, RCN lead nurse for end of life care, said: ‘A lot of this is about common sense – about what would you do instinctively. And we’ve terrified nurses into not doing things instinctively.
‘It’s become about doing a job, a task, writing a form, doing a really good care plan – all of which are terribly important but we do need to use our common sense and our instincts more perhaps than some people do.’
Dr Kevin Stewart, a geriatric medicine consultant who leads the RCP’s unit on clinical effectiveness, said: ‘There are care homes who aren’t clued up about nursing care and the help needed, who just panic when it looks like someone is dying and call 999.’
An NHS England spokesperson said: ‘We welcome the results of this audit, which we commissioned, and which show there has been some improvement in the care provided.
‘But there is clearly more that can be done.
‘Although this audit presents a snapshot of end-of-life care within NHS hospitals, there are clear variations in the support and services received across hospitals and areas where improvements must continue to be made.’
Families not told about ‘do not resuscitate’ orders