Coronavirus: UK regulator warns over treatment of most vulnerable

Covid-19 should not be used as an excuse to persuade patients to sign up to “non-revival” orders, says chief nurse

Health Secretary Matt Hancock at a during a Covid-19 press conference in London. Reuters

UK doctors have been told not to use the Covid-19 pandemic as a reason to restrict life-saving treatment for the elderly and most vulnerable in society.

The country’s chief nurse, Ruth May, said the huge upheaval caused by coronavirus should not give doctors an excuse to have untimely discussions about whether they should be resuscitated.

The medical regulator on Friday said it had written to medical practices to warn it was “unacceptable” not to assess patients individually before they completed a “do not resuscitate” form.

A do-not-resuscitate order is written by a doctor telling other health professionals not to revive someone if their breathing or heart stops. The order is only written after discussions with the patient or the patient’s family.

Even if a patient has not agreed to an order, doctors still have the ultimate decision on whether reviving someone is ‘futile’ because of underlying health conditions, say lawyers and medical professionals.

Ms May said clinicians were continuously having discussions about the prospects of resuscitation for those with serious illnesses. “Covid-19 is no excuse to have those discussions in an insensitive way,” she said.

An opposition MP, representing a constituency on the south coast of England, said that elderly residents of care homes were being encouraged to sign DNR orders “en masse”.

“It’s very clear that the people who are directing health locally and regionally are encouraging people who are running care homes to get their residents to sign DNR orders,” the MP, Peter Kyle, told the BBC.

“It’s a very strong indicator they are not going to send people to hospitals when they get ill,” he added.

Matt Hancock, the UK health secretary, said there was no “blanket rule” that elderly patients should not be taken to hospital from care homes to ensure there was enough space for younger patients.

“There are 2,029 spare critical care beds in the NHS right now,” he said. “There is capacity in the NHS right now to deal with Covid-19.”

The issue has come to the fore after one surgery apologised after sending a letter to people with serious health conditions like incurable cancer suggesting they signed the documents.

The letter from Llynfi Surgery in Maesteg, south Wales, said people with serious conditions were “unlikely to be offered hospital admission” and would not be given a ventilator bed.

“We will not abandon you but we need to be frank about what the next few months holds for us,” the letter said.