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Health officials told care homes to impose ‘Do Not Resuscitate’ orders on all residents during pandemic's peak

A “SCANDALOUS” blanket Do Not Resuscitate (DNR) order placed on care home residents prompted outrage today, with Labour and charities demanding an explanation from health officials.

As the Covid-19 pandemic headed to its peak, care homes were told by NHS managers to impose DNRs on all of their residents, the Queen’s Nursing Institute (QNI) has found, abandoning autistic adults, people with learning disabilities and elderly people to their fate without giving them a fighting chance to survive infections.

According to the institute’s research, one in 10 care homes were given the order without discussion with staff, the residents or their families. 

Report author Professor Alison Leary has called for an inquiry. 

A DNR order is designed to prevent unnecessary suffering and is used in circumstances where performing CPR will not restart the heart or breathing, has no benefit to the patient or when the benefits are outweighed by the burdens.

The British Medical Association and the Royal College of Nursing state that DNR orders should only be issued following discussions with patients or their family.

Shadow health minister Jonathan Ashworth said: “It’s scandalous that blanket DNR orders were used. Ministers should have done everything to protect care home residents. 

“To have left care home residents and staff not just unprotected and exposed to Covid-19 but to have put in place procedures that actively allowed Covid-19 to spread in care homes is an atrocious failure of Boris Johnson.  

“Instead, families are left with the tragic consequences of heartbreaking loss of life.”

National Autistic Society head of policy and public affairs Tim Nicholls said the findings will be really worrying for autistic people and their families. 

“Being autistic should never stop you getting lifesaving treatment. Anything short of this is completely unacceptable,” he said.

“We were deeply concerned when we first heard stories about GP surgeries approaching families to suggest that they should have plans in place to prevent [relatives] from being resuscitated if they were to fall critically ill. 

“We raised this immediately with health and government officials. NHS England stated very clearly that there should be no blanket decisions applied to individuals. 

“All health professionals should follow that instruction and respect autistic people’s wishes.”

The QNI report is the latest in a series of revelations on how the government neglected care homes throughout the pandemic.

In April, charities warned that elderly patients were being pressured into signing DNR forms, while a month later care home managers said that people with learning disabilities were being denied coronavirus tests.

At the time, Keep Our NHS Public co-chairman Dr John Puntis said that government, policymakers, managers and clinicians “have a responsibility to patients to ensure that any system used to assess patients for escalation or de-escalation of care does not disadvantage any one group disproportionately.”

Ceri Smith, head of policy and campaigns at disability equality charity Scope said: “It’s alarming to hear of hugely significant measures like DNR orders being imposed on disabled people without even telling them or their families.

“We understand the NHS has been under enormous pressure and has to make complicated decisions, but discriminatory actions like this create a climate where disabled people feel forgotten and under-valued.

“Disabled people should never be treated as expendable, whether we’re in a global pandemic or not.”

Age UK charity director Caroline Abrahams said: “These findings confirm the anecdotal reports about what was going on in care homes in March and April and, as such, they are cause for enormous sadness and concern.

“In March and April, Covid-19 was on the rise and everyone was worried that our hospitals could become overwhelmed. 

“This helps to explain these findings — but it cannot excuse all the actions that were taken, nor the discriminatory attitudes that they betray.  

“Nothing like this must ever happen again, and it’s the responsibility of leaders in government and the NHS to ensure that if Covid-19 resurges this winter, older people in care homes get the good care and access to medical treatment that they have a right to and should legitimately expect.” 

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