Regional DNACPR Policy
Steve Barnard, Head of Clinical Governance,
North West Ambulance Service NHS Trust
Steve.barnard@nwas.nhs.uk
Background
 Perceived lack of DNACPR Policy across NW in
community setting
 High degree of variance regarding DNACPR
documentation/recording
 Variable/lack of communication – patient,
professional & organisational
 Lack of policy integration between care settings and
services
Delivering the right care, at the right time, in the right place
National DNACPR Developments
 National EoLC Programme developing principles
 North East produced Deciding Right
 Deciding Right includes Emergency Health Care
Planning, ADRT and DNACPR
 East of England and South Central SHAs have
implemented single DNACPR Policies with standard
forms.
 Indication that national principles will reflect
Deciding Right publication
Delivering the right care, at the right time, in the right place
Regional DNACPR Developments
 Implementation of Regional DNACPR policy is part of
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NW EoLC QIPP Project
NHS NW have agreed to adopt NW regional
approach
Agreement to unify DNACPR Policy only
Adopt similar approach to South Central SHA
NWAS to act as project lead and support
NHS NW to write to Cluster Chief Executives for
expressions of interest for early adopter sites.
Delivering the right care, at the right time, in the right place
Regional DNACPR Concept
 Unified regional approach to organisation policy
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design.
A common decision making process for DNACPRs
A common communication and info sharing process
A common policy statement to enable validity of
DNACPRs for 7 days following a change in care
setting.
A single DNACPR document for all settings
Individualised roles, responsibilities, procedures and
governance
Delivering the right care, at the right time, in the right place
Project Benefits
 Supports a more integrated approach across
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different care settings and organisations - offering
potentially seamless care and reducing the risk of
inappropriate clinical decisions
Improved communication with patients and carers
Improved information sharing between organisations
– more robust and timely
A potential reduction in 999 demand
A potential reduction in inappropriate admissions
Delivering the right care, at the right time, in the right place
Project Structure
 Single NW DNACPR Project Board
 Early adopter sites identified at Cluster-level with
Cluster-level Project Groups.
 Criteria for early adopters to include:
– The cluster has at least 2 acute trusts who are
willing and have agreed to work in partnership
with their local PCT/community services as part of
the pilot.
– The cluster (or organisations involved) can commit
to working towards the timescales indicated.
Delivering the right care, at the right time, in the right place
Timescales
 Implementation of the unified NW DNACPR policy is
required by the end of March 2013
 Identification of pilot sites is required by the 1st
February 2012
 Agreement of common NW DNACPR principles and
documentation by 1st April 2012
 Go live with first wave of early adopters by 1st June
2012
Delivering the right care, at the right time, in the right place
Questions?
Delivering the right care, at the right time, in the right place