NHS care homes told to put ‘Do Not Resuscitate’ orders on all residents at Covid peak

Survey suggests one in ten managers and nurses were told to change DNRs without discussion with patients, relatives or fellow staff

NHS Care Homes
(Image credit: Christopher Furlong/Getty Images)

Care homes were told to introduce blanket “do not resuscitate” (DNR) orders for all residents at the height of the coronavirus pandemic, according to a new report.

A survey of 128 care home managers and nurses by the Queen’s Nursing Institute charity found that one in ten of the institutions was ordered by NHS bosses to introduce DNRs without permission from the residents, family members or fellow staff, in order to free up hospital beds.

Half of the staff members who said they had been asked to change DNRs worked in homes for the elderly, while the other half worked in homes for younger people with learning or cognitive disabilities, The Times reports.

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A fifth of the survey respondents also said that they received residents from the hospital sector who had tested positive for Covid-19 during March and April.

An unnamed respondent told the researchers that care homes “were advised to have [DNR orders] in place for all residents”, adding: “We acted in accordance with medical advice and resident wishes, not as advised by a directive to put in place for all by a clinical care group representative. We challenged this as unethical.”

Report author Professor Alison Leary has described the findings as “worrying” and is calling for a public inquiry.

“These decisions were being made by NHS managers not clinicians,” Leary, a professor of healthcare and workforce modelling at London South Bank University, told The Telegraph.

She added that “the way the situation for care homes has been handled needs a retrospective view, particularly because winter is coming, which is always a difficult time” for the elderly and other vulnerable people.

Reports over the treatment of residents in care homes hit by Covid outbreaks sparked widespread outrage back in April. In response to the public anger, ministers forbid the use of blanket DNR agreements and instructed the Care Quality Commission to “urgently” tell homes to tear up agreements that “would stop residents getting access to full healthcare if they choose it”, as the London Evening Standard reported at the time.

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