Do Not Attempt Resuscitation (DNAR) Policy - Dudley Primary Care ...

Please note that there are now two new forms (appendix 1) to document
and transfer the information across to Out Of Hours providers and West
Midlands Ambulance Service (WMAS).
6.2 Part one of the form is the DNAR document and may replace the
organisations existing form. However if a DNAR form has already been
made and is valid then there is no need to replace it. This form must
stay with the patient held notes in the patient’s own home and must not
on any account be photocopied.
6.3 Part two of the form is the document required to transfer the information
to WMAS. This information may be the DNAR status of the patient but
may also be other information regarding end of life care, management
and or patient preferences regarding place of care. This part of the form
is to be faxed to WMAS (using the safe-haven fax number on the form).
6.4 By following the guidelines on the form the patient’s DNAR status, and or
other end of life care preferences or management, will be registered with
WMAS. In the event of an emergency call to the ambulance service the
crew will then be aware that there is a DNAR document in the house and
will also have additional information if the special patient notes have
been completed as well.
6.5 WMAS will confirm receipt of the fax within 30 minutes of receiving it and
will inform the named clinician on the form if they are called to the
patient.
6.6 The clinician completing the form is responsible for informing WMAS of
any changes to the patient clinical status, including DNAR status, if the
patient dies or if the patient has changed address.
6.7 If WMAS are called out to the patient they will inform the lead clinician of
the outcome on the next working day.
6.8 The form can also be faxed to Medical and District Nursing OOH using
the existing arrangements for special patient notes for palliative and end
of life care patients.
7. Clinical and Professional Conflict Resolution
7.1 Where there is clinical and professional conflict over the decision taken
about the patient’s resuscitation status, urgent decisions must take place
between the Senior Medical Practitioner and the local manager. If the
matter cannot be resolved at local level, then the Medical Director and
senior management lead must be involved as a matter of urgency. As
this is a complex area of law the Consultant or GP may also wish to seek
specific legal advice via the Chief Executive’s Office.
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