Families’ legal action pledge over Do Not Resuscitate orders

Two families are looking at legal action over DNR orders on their loved ones

Two families say they will take legal action over Do Not Attempt Resuscitation (DNAR) orders made on their loved ones at QEQM Hospital in Margate.

Birchington construction worker Terry Bolton and Whitstable businessman Alan Barker plan to challenge the decisions and the reasons behind them.

The moment Carol said sat up and asked for a cup of tea

Terry’s mum Carol was being treated as end of life for a month, with the family believing she would die due to Covid after being told her organs were ‘breaking down’.

Carol defied those predictions and is now recovering in Kent & Canterbury Hospital.

Lorraine died on Christmas Eve, leaving behind her husband and two children

Alan says the order made on his wife Lorraine, who sadly died on Christmas Eve, was a breach of her rights and he has sought legal advice.

He complained to the hospital trust about pressure placed on the family over applying a DNAR decision.

Both men have now made official requests for access to the medical files of their loved ones and Alan says he is taking specialist advice to bring a case.

Several other Thanet residents have raised concerns over use of the orders.

One woman says she is in the process of legal action over her mum’s death and another says she was treated for Covid and, after her discharge, was distressed to find a DNAR had been placed on her records without her knowledge.

‘Sensitively and honestly’

East Kent Hospitals Trust, which is responsible for sites including QEQM, says a decision not to attempt resuscitation is never taken lightly.

The Trust added that discussions and support are offered to patients and their families where possible to ensure all questions and other issues can be addressed sensitively and honestly.

A spokesperson said: “In situations where a person’s clinical condition is deteriorating despite medical treatment, it is not always appropriate to attempt resuscitation if their heart or breathing stops because the outcome of any attempt at resuscitation would not be successful at that time.

“A decision not to attempt to resuscitation is never taken lightly and discussions and support are offered to patients and their families where possible to ensure all questions and other issues can be addressed sensitively and honestly.

“The outcome of any discussions with the patient and all of the clinical information is then recorded in the patient’s notes to ensure everyone involved in the patient’s care is fully aware of the situation.”

In 2018 a Care Quality Commission report said areas for improvement at East Kent Hospitals Trust included ensuring “that consent to care and treatment is always sought in line with legislation” in regards to DNARs.

In 2015 the trust admitted breaching the human rights of a 51-year-old man after two DNACPR (Do Not Attempt Cardiopulmonary Resuscitation) orders were placed on his records in 2011, giving his disability of Down’s syndrome as one reason, without the knowledge of his family.

Court findings on DNR process

A court judgement in 2014 over the process of DNAR/ DNACPR use in hospitals found that staff must consult patients unless the clinician believes the distress caused by the discussion will harm the patient.

In those cases they must document their reasons and take reasonable steps to involve the patient’s family in the discussions. But the law does not require a patient or their family to consent to a DNAR order. A doctor can issue an order, even if the family do not want one, if medical evidence necessitates.

Health watchdog DNAR national review

The Care Quality Commission (CQC) is carrying out a national review into the application of DNACPR decisions during the Covid-19 pandemic.

Early findings show that while there is no evidence to suggest blanket approaches to DNACPR decisions, people told CQC that early in the pandemic they or their loved ones received DNACPR decisions which were not based on their wishes and needs, and without their knowledge and consent.

The CQC review continues, with the results due to be published in the early part of this year.

Rosie Benneyworth, Chief Inspector of Primary Medical Services and Integrated Care at the Care Quality Commission, said: “It is unacceptable for clinical decisions – decisions which could dictate whether someone’s loved one gets the right care when they need it most – to be applied in a blanket approach to any group of people.

“Sadly, in the experiences that people have generously shared with us there is very real concern that decisions were made which not only overlooked the wishes of the people they affected, but may have been made without their knowledge or consent.

“As we warned in our recent State of Care report, these findings highlight that inequalities in the care people receive risk being magnified by the impact of the coronavirus pandemic. As this is such an important and sensitive issue, we have worked quickly to share the interim findings and we will continue this work so that we build on the evidence already shared and can make recommendations for the future.

“It is vital that we look at what happened on the ground, continue to speak to people using services and people working in them, so that we can make sure that the health and care system learns the crucial lessons it needs to from this difficult time.

“We have also highlighted the fact that it is possible in some cases that inappropriate DNACPRs remain in place – and made it clear that all care providers have a responsibility to assure themselves that any DNACPR decisions have been made appropriately, in discussion with the person and in line with legal requirements.”

16 Comments

  1. These families should be supported against this being done against people’s wishes. I had to visit the QEQM recently with a shoulder problem. While waiting to go home a nurse came running from A&E have you filled in the red form I was baffled I asked what that was she said DNR form I replied why do I need one of those I came in for a shoulder injury at the end I saw a GP. I did notice since covid if you visited the hospital when you visited they used to write to you with discharge papers giving you the outcome. This seemed to have stopped since covid. This needs looking in to.

    • They seem to run around like headless chickens. All over the country they have been putting people going in with a temperature, cough etc onto Covid wards without testing them, leading to people with other issues contracting is as a result-it will eventually come out just how many the NHS has killed & put insane levels of increased pressure on themselves with their abysmal leadership & planning during this pandemic.

      How soon people forgot once Covid hit & we were supposed to start clapping to the sky that the the East Kent Trust was & remains under investigation for the unnecessary deaths of babies due to incompetence & negligence-fueled by an arrogant leadership who repeatedly refused to implement the recommended safety recommendations from the HSIB & fought the families all the way as usual. East Kent Hospitals went from public enemy number one to superhero angels overnight.

  2. I would advise all relatives to be very careful of getting involved with the legal bods, a relative took legal action over a matter and the trust offered £15000 which the lawyers said was a very good offer and should be accepted. After settlement the legal fees came to £12000 leaving just £3000 compensation.

    • Is that the objective? To get as much money as possible out of the NHS?
      Money that could be spent on desperately needed staff and equipment?

      • Most likely it ends up in the fat cat bosses bonuses. There is very little recourse but to sue when they mess up & ruin your earning capabilities or life in general. We all accept that things can go wrong on the table which is out of their hands & sign a waiver to that effect before surgery, but that doesn;t cover incompetence or reckless behaviour like Rodney Ledward or Ian Paterson for instance.

  3. Andrew, when they carry out the wrong operation on you, you can just thank the Docs for incompetence and tell them to keep any compo for themselves. The patient lost nearly a year of their income as a result.

  4. Quite right that questions are asked, and people held to account for the decisions they have made.
    But no amount of money is going to bring back a dead relative.
    All it will do is hit the NHS in the pocket: ie, you and me.

  5. After baby deaths
    After someone I know told to go home nothing wrong drops down dead.
    I trust no one at QEQM
    It beggars belief who sits on the clinical side.. The ones who control the money.
    To make mistake after mistake on babies it should close down.

    I knew about this before the screamed pandemic. All those in hospital are DNR…

  6. An acquaintance in Berks this year in her early 60s found she had a DNR put on her in hospital, when a consultant questioned it on her release. They were both shocked and her husband had no knowledge either. She had survived the virus after she was told she was going to die and having being placed on a ventilator. She found the whole thing extremely disturbing and is pursing it with the hospital.

  7. Be sure of this there is not one Organisation big or small that does not make mistakes of one sort or another some obviously with fatal consequences be it an airliner a cruise ship and hospitals. There are only so many beds in ITU so if they are all full the age and prognosis of those patients in the ITU beds are taken into account if it’s younger patients waiting who need the ITU bed the older patient are the ones who are who are most likely to have the machine switched off If clinically there is no point in constantly inflating their lungs just to keep their heart ticking you could do that for years but it wouldn’t make a them any better. Some years ago there was I consultant who was telling women in the private sector that they had breast cancer when they didn’t and he was removing their breast that man is now in person serving a very long sentence as he should be.

  8. Rebecca hooper you are right on this one it’s in all three hospitals not only the QEQM it happens at the Kent and Canterbury and the William Harvey in Ashford don’t agree with closing down our local hospital it’s the person at the top and the staff they employ. A lot of them shouldn’t be working in the NHS.

  9. If you’re not happy with the service and facilities of the NHS you can always go private. I’m sure that you’d better much better treatment there.

  10. Phyllis’s qioit many people cannot afford private health care but many people I know who have private insurance that sector is not treating private patients as well you get the same service in the NHS as well as private. A lot of NHS surgeons will not do necessary operations in our hospitals but happy to do the same operations in a private hospital. They should not be allowed to moonlight in the private sector.They are employed by the NHS through the trust.

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