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People with a learning disability were left without essential support during the Covid-19 pandemic due to visiting restrictions, according to the latest report from the UK Covid-19 Inquiry.
Additionally, several witnesses described patients, their families, or carers only discovering that a Do Not Attempt Cardiopulmonary Resuscitation notice (known as DNACPR) had been put in place after their loved one had died or been discharged from hospital. There were also reports of these notices being inappropriately applied to people with a learning disability.
The third report from the Inquiry examined the impact of Covid-19 on healthcare systems across the four nations, how governments and society responded to the pandemic and the impact on patients and their loved ones.
The Chair of the Baroness Heather Hallett concluded that the UK’s healthcare systems “came close to collapse”. Ultimately, it “coped, but only just”.
Advance care planning in Covid-19 pandemic
The Inquiry now recommends adopting a single, consistent advance care planning form across the UK, such as the ReSPECT form.
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The form must ascertain and record the patient’s wishes and preferences for future care and treatment to inform individualised decision-making, including DNACPR. Relevant health professionals should receive training on the process of advance care planning and DNACPR decisions, and training to enable them to communicate sensitively with patients and families concerning these decisions.
Jackie O’Sullivan, director of strategy and influence at Mencap, said: “Looking back at what the Inquiry has uncovered, it’s impossible not to feel furious. People with a learning disability were given DNACPR decisions without their agreement and in some cases were told they wouldn’t be resuscitated simply because of their disability.
“It was shocking discrimination then and it remains shocking discrimination now. No one should ever have their life written off in this way and this must never be allowed to happen again.”
Recommendations from the Inquiry
The Inquiry also recommends:
- increasing capacity in urgent and emergency care and ensuring that hospitals have the ability to implement surge capacity;
- strengthening the body responsible for infection prevention and control guidance, broadening its membership to enhance its decision-making and improving the guidance itself;
- improving data collection, enabling individuals at highest risk of harm from infection to be more easily identified and recording deaths of healthcare workers more accurately;
- promoting a standardised process and documentation for advance care planning, recording patients’ preferences for future care and treatment;
- increasing support for healthcare workers, improving retention and increasing resilience; and
- publishing guidance to assist decision-makers, providing clear criteria for clinical decisions if critical care resources become completely exhausted.
