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Patients may have received inappropriate “do not resuscitate” orders from doctors who made general decisions during the first wave of the pandemic, the care watchdog said.
Complaints about orders not to attempt cardiopulmonary resuscitation (DNACPR) rose to 40 between March and September, compared to nine in the previous six months, the Commission on Quality of Care (CQC) said.
An investigation by the CQC found that DNACPR may have been used inappropriately as care services were under extreme pressure and had not understood the guidelines on their use.
In one case, a caregiver said an on-call doctor had told nursing home staff that any resident who contracted COVID-19 would have a DNACPR order in effect.
Another witness said GPs told some learning disabilities nursing homes and services to make blanket requests for everyone in their care.
The resuscitation procedure can cause punctured lungs, fractured ribs, and severe bruising, and only 15-20% of people survive in the hospital.
Outside of the hospital setting, survival rates fall between 5 and 10%.
But the CQC guidance states that not offering all options to patients and their families is a violation of their human rights, and that general decisions should never be made about DNACPR.
The watchdog said it had received evidence from patient staff and families that some orders had been applied without consultation.
In some cases, families did not know that the order was in effect until their relative felt ill.
Others said they had been told that their loved one agreed to an order from DNACPR, but were concerned that there had been a misunderstanding due to factors such as a language barrier or deafness.
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Caregivers speak of COVID distress
The CQC said there are also examples of routine care not being provided at home, such as an ambulance or a doctor not being called, due to a DNACPR order that was in effect.
The watchdog warned that inappropriate DNACPR orders may still exist for some people.
Rosie Benneyworth, chief inspector of primary medical services and integrated care at the CQC, said: “It is unacceptable that clinical decisions, decisions that could dictate whether someone’s loved one receives the right care when they need it most, are applied in blanket approach to any group of people “.
An NHS spokeswoman said: “The NHS has repeatedly instructed local physicians that the general application of DNR would be totally unacceptable and that access to treatment and care for people with learning disabilities and autism should always be done on an individual and in consultation with family and caregivers. “
