Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the number of NHS Trusts in England allowing physician associates to prepare recommended summary plan for emergency care and treatment (ReSPECT) forms and apply do not resuscitate orders; and whether they consider this practice to be legal and appropriate.

The Department and NHS England do not hold data on individual Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions at National Health Service trusts in England.

ReSPECT is a process which records personalised recommendations for a person’s clinical care and treatment for a future emergency in which they are not able to make decisions or to express wishes. These recommendations, including a cardiopulmonary resuscitation (CPR) decision, are developed through conversations between a person and the health care professionals involved with their care. Recommendations are recorded on a non-legally binding form.

The Resuscitation Council UK has produced guidance for organisations and healthcare professionals using the ReSPECT process. CPR decision policies are determined locally by organisations providing NHS care.

The Resuscitation Council UK, the British Medical Association, and the Royal College of Nursing have jointly produced guidance on decisions about CPR. It states that the overall clinical responsibility for decisions about CPR, including DNACPR decisions, rests with the most senior clinician responsible for the person’s care as defined explicitly by local policy.

The Government has commissioned Professor Gillian Leng CBE to lead an independent review of the physician and anaesthesia associate professions. It will consider the safety of the roles and their contribution to multidisciplinary healthcare teams. The conclusions of the review will inform the workforce plan to deliver the 10-Year Health Plan.

The review will consider the approach that was adopted in England to support the safe introduction, employment, and deployment of these new roles.