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All Wales Review of Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) Decisions

The aim of our review is to consider the practices in place when DNACPR decisions are applied to adult patients (over the age of 18), and whether patient views and considerations are respected.

We will consider whether DNACPR decisions reflect the priorities of the individual, as well as their preferred information requirements, and whether a DNACPR decision is clearly recorded and communicated between healthcare professionals, and with the patient and those close to them.

Our research and stakeholder engagement has helped inform the scope of our work, of how to answer the question:

  • Are DNACPR decisions being respectfully communicated to patients and those close to them, and are they clearly recorded and communicated between healthcare professionals?

Our key lines of enquiry will include:

  • Is DNACPR documentation in medical records (and not just the DNACPR forms) robust?
  • Does the DNACPR documentation appropriately reflect the communication with patients, and with those close to the patient?
  • Is there evidence of communication of a DNACPR decision across different healthcare teams?
  • How do clinicians consider the communication needs of people to ensure they fully understand the DNACPR decision making process?
  • What measures do healthcare organizations have in place to ensure clinicians consider equality and diversity when making DNACPR decisions?

The review will conclude with the publication of a national report in spring of 2024. The report will highlight key themes and areas of good practice and will make recommendations where required improvements are identified throughout our review.

The terms of reference for the review are attached below.