Written question WQ93040

We are committed to working with the All-Wales Advance and Future Care Planning Strategy Group to improve the do not attempt cardiopulmonary resuscitation (DNACPR) process.

The all-Wales DNACPR policy for adults has been in use since February 2015 and is reviewed every two years. The 2024 review is currently underway.

In 2020, the DNACPR policy and form was updated to enable a wider range of healthcare professionals to lead and facilitate a DNACPR conversation and decision. A competency framework was produced for health boards, trusts and other health care partner organisations in Wales to use, to support identified registered healthcare professionals to receive appropriate training and demonstrate key competencies to hold fully informed DNACPR conversations with adults.

Continued education is vital to improving how DNACPR decisions and conversations are communicated, and to ensure forms are correctly and consistently filled in. Education and training are provided via the national programme for advance and future care planning through seminars, care home training and written modules and e-learning for end-of-life care, most of which is supported by direct patient/carer input.

Health boards must ensure that there is a rolling programme of audits for DNACPR, at least every two years, and that challenges and action plans are presented to local quality and safety boards (or equivalent clinical governance organisational oversight structures), to swiftly address findings.

In addition, Healthcare Inspectorate Wales recently published a review of DNACPR decisions for adults in Wales, which highlighted areas of good practice and areas for improvement. We will carefully consider the report’s recommendations, together with health boards, trusts and the Advance and Future Care Planning Strategy Group.