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‘ReSPECT process will start difficult conversations earlier’

Dates: 14, May, 2018 Category: CCG News

Adam Brown is Consultant in Palliative Medicine at St Barnabas and United Lincolnshire Hospitals Trust. Here he talks about the ReSPECT process being launched in Lincolnshire……

To many of us, death is still a taboo subject. We find it difficult to talk about and often don’t want to discuss our wishes with our loved ones.

But it is important that we all feel comfortable enough to talk about how we would want to be treated in the event of an emergency situation that may require CardioPulmonaryResuscitation (CPR) treatment.

In 2014, the Royal Society of Medicine produced a systematic review of Do Not Attempt CPR decisions and documents. They agreed on a need to improve patient and family involvement in decision making.

This was so CPR decisions would be considered in the context of broader care and treatment and to record the outcome on a form that would be used and recognised across the UK.


That is why now in Lincolnshire, we have come together with NHS Lincolnshire West Clinical Commissioning Group and other key stakeholders to develop and roll out the ReSPECT process in the county.

ReSPECT stands for Recommended Summary Plan for Emergency Care and Treatment.

The ReSPECT process initiates and supports conversations and shared decision-making between healthcare professionals and people, including their families and carers, by following a simple process that develops a shared understanding of a person’s condition, circumstances and future outlook.

Care preferences

It then explores that persons preferences for their care and realistic treatment in the event of a future emergency. It then goes on to making and recording agreed clinical recommendations for their care and treatment in a future emergency in which they have lost the capacity to make or express decisions.

ReSPECT is about awareness and initiates those potentially difficult conversations. That is why we are announcing the plan during the Dying Matters Awareness Week which also aims to encourage people to feel comfortable talking about how they want to be treated in an emergency or as they come towards the end of their life.

This new initiative will provide more clear guidance from patients than the previous DNACPR orders and is focusing on patient choices and involvement.

Earlier conversations

But ReSPECT allows people to have these conversations earlier on, and to cover a wider range of treatment than just CPR. We want these conversations to be had between families, patients and health care professionals about how individuals want to be treated and what they want their treatment plan to look like.

The hope is that by completing a ReSPECT form, it will provide health and care professionals responding to an emergency with a summary of recommendations from patients. This will help them to make immediate decisions about that person’s care and treatment.

The ReSPECT process will hopefully be launched in Lincolnshire in the near future. If anyone has any questions about the ReSPECT process, please visit

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