DCCG PC – Respect (Creating personalised recommendations for a persons clinical care)

For more information regarding ReSPECT, please visit: https://www.respectprocess.org.uk/

What is the ReSPECT process?

The ReSPECT process creates individualised recommendations for a person’s clinical care in emergency situations, including cardiorespiratory arrest, in which they are not able to decide for themselves or communicate their wishes. The process involves a conversation which:

  1. develops a shared understanding of a person’s condition, circumstances and future outlook
  2. then explores that person’s preferences for their care and realistic treatment in the event of a future emergency
  3. then goes on to make and record agreed clinical recommendations for their care and treatment in a future emergency in which they cannot make or express decisions at the time.

Why has the ReSPECT process been created?

For many years there has been debate over the use and design of DNACPR forms, together with a recognition of their limitations. The ReSPECT process was created following a systematic review of DNACPR decisions and documents. An approach that focuses only on withholding CPR in people who are dying or for whom CPR would offer no overall benefit has resulted in misunderstandings, poor or absent communication and poor or absent documentation. ReSPECT aims to encourage patient and family involvement in decision-making, to consider recommendations about CPR in the context of broader plans for emergency care and treatment, and to record the resulting recommendations on a form that would be used and recognised by health and care professionals across the UK.

Who is the ReSPECT process for?

This process can be for anyone, but is especially relevant for people:

  • with particular health needs that may involve a sudden deterioration in their health
  • with a life limiting condition, such as advanced organ failure, advanced cancer or frailty
  • at risk of sudden events, such as epilepsy or diabetic crisis
  • at foreseeable risk of death or sudden cardiorespiratory arrest
  • who want to complete the ReSPECT process and documentation for other reasons.

Do the recommendations on the ReSPECT form have to be followed?

In certain situations healthcare professionals may decide not to follow the recommendations on a ReSPECT form. For example, if someone has a ReSPECT form stating that they would not want to receive attempted CPR, clinicians may feel that they have to give treatment if someone stops breathing as a result of choking