1. Regional DNACPR Policy Steve Barnard, Head of Clinical Governance, North West Ambulance Service NHS Trust Steve.barnard@nwas.nhs.uk

2. Delivering the right care, at the right time, in the right place Background  Perceived lack of DNACPR Policy across NW in community setting  High degree of variance regarding DNACPR documentation/recording  Variable/lack of communication – patient, professional & organisational  Lack of policy integration between care settings and services

3. Delivering the right care, at the right time, in the right place National DNACPR Developments  National EoLC Programme developing principles  North East produced Deciding Right  Deciding Right includes Emergency Health Care Planning, ADRT and DNACPR  East of England and South Central SHAs have implemented single DNACPR Policies with standard forms.  Indication that national principles will reflect Deciding Right publication

4. Delivering the right care, at the right time, in the right place Regional DNACPR Developments  Implementation of Regional DNACPR policy is part of NW EoLC QIPP Project  NHS NW have agreed to adopt NW regional approach  Agreement to unify DNACPR Policy only  Adopt similar approach to South Central SHA  NWAS to act as project lead and support  NHS NW to write to Cluster Chief Executives for expressions of interest for early adopter sites.

5. Delivering the right care, at the right time, in the right place Regional DNACPR Concept  Unified regional approach to organisation policy design.  A common decision making process for DNACPRs  A common communication and info sharing process  A common policy statement to enable validity of DNACPRs for 7 days following a change in care setting.  A single DNACPR document for all settings  Individualised roles, responsibilities, procedures and governance

6. Delivering the right care, at the right time, in the right place Project Benefits  Supports a more integrated approach across different care settings and organisations - offering potentially seamless care and reducing the risk of inappropriate clinical decisions  Improved communication with patients and carers  Improved information sharing between organisations – more robust and timely  A potential reduction in 999 demand  A potential reduction in inappropriate admissions

7. Delivering the right care, at the right time, in the right place Project Structure  Single NW DNACPR Project Board  Early adopter sites identified at Cluster-level with Cluster-level Project Groups.  Criteria for early adopters to include: – The cluster has at least 2 acute trusts who are willing and have agreed to work in partnership with their local PCT/community services as part of the pilot. – The cluster (or organisations involved) can commit to working towards the timescales indicated.

8. Delivering the right care, at the right time, in the right place Timescales  Implementation of the unified NW DNACPR policy is required by the end of March 2013  Identification of pilot sites is required by the 1st February 2012  Agreement of common NW DNACPR principles and documentation by 1st April 2012  Go live with first wave of early adopters by 1st June 2012

9. Delivering the right care, at the right time, in the right place Questions?