Care home residents are being denied access to healthcare due to the incorrect us of ‘do not attempt CPR’ orders, according to new research.

Researchers at Essex University called for urgent reform of the process for making DNACPR recommendations and improved training for care professionals and those advocating for care home residents.

“Some residents are being inappropriately denied transfer to hospital or access to certain medicines. The best way to describe it is a form of ‘mission creep’ of DNACPR recommendations being used beyond their intended remit,” said principal investigator professor Wayne Martin.

In the findings, published in the British Journal of Social Work, 17% of care home workers in England said they had witnessed DNACPR recommendations informing care and treatment decisions beyond cardiopulmonary resuscitation.

More than half (55%) reported that DNACPR recommendations were made without consulting with the individual or their families.

In addition, 56% reported new DNACPR decisions being recorded during the pandemic and 28% said DNACPR orders were being added because of blanket decisions based on characteristics such as age.

There was also evidence of widespread confusion among professionals about the meaning and legal status of DNACPR recommendations with 66% at one training event led by the Essex researchers wrongly believing that DNACPR recommendations are legally binding.

Professor Martin Green, chief executive of Care England, told Caring Times: “DNRs should only be used with the full consent of the citizen and their loved ones. Medical professionals can give advice on these issues, but ultimately, it is for citizens and their loved ones to have the final say over whether or not a DNR order is in place.”

A CQC spokesperson said: “Personalised and compassionate advance care planning, including DNACPR decisions, is a vital part of good quality care. Done properly, it can offer reassurance and comfort for people and their loves ones – before and during difficult times.

“As we highlighted in our review of DNACPR decisions during the pandemic, it is vital the health and social care system gets this right and ensures better end-of-life care, with health and social care providers, local government and the voluntary sector working together.”

A Department of Health and Social Care spokesperson said: “It is totally unacceptable for ‘do not attempt CPR’ (DNACPR) orders to be applied in any kind of blanket fashion – this has never been government policy.

“We will continue to work with partners to ensure guidance on DNACPR is clear and properly understood in all settings.”