ReSPECT FAQs

The ReSPECT process empowers you to guide healthcare teams about the treatments you would or would not want to be considered for. The plan you make together can record treatments that could be important and / or those that would not work for you.

Treatments that can be life-sustaining for some people carry a risk of causing harm, discomfort or loss of dignity. Many people choose not to accept that risk if the likelihood of benefit from treatment is small. Your ReSPECT plan records your preferences and the agreed realistic recommendations for emergency situations, whatever stage of life you are at.

The ReSPECT process has already been adopted across Nottinghamshire and by NUH joining the process ensures that your clinical care wishes are known across all care settings. Your wishes can then be considered in a medical emergency if you are too unwell to explain them yourself. 

Your ReSPECT plan can be used across a range of health and care settings, including your own home, an ambulance, a care home, hospice or hospital.

Read more here about ReSPECT being introduced across the UK. Countries of the UK are at different stages in this process: https://www.resus.org.uk/respect/respect-patients-and-carers/respect-adoption-uk

A ReSPECT plan includes a section about CPR. After a full discussion with you, the plan will say either CPR attempts are recommended, or CPR attempts are not recommended.

As CPR forms part of the ReSPECT plan it is important that we help you to understand about CPR. You will then be better able to discuss CPR with your healthcare team.

CPR stands for cardiopulmonary resuscitation. This emergency procedure tries to restart someone’s heart and or breathing if they stop.

The heart and breathing can stop for many different reasons. This is why CPR helps some people but not others. CPR does not treat the problem that caused the heart or breathing to stop, but sometimes CPR can restart the heart and breathing so that other treatment can be given.

 

Ask your GP to have a ReSPECT conversation with you so that you can make a plan together. Your GP often knows your health and care needs best and can complete the document with you. You could also ask your specialist doctor or nurse if you have regular outpatient appointments for a chronic condition or longer term illness. Some people find it helpful to have this conversation when they are reasonably well so that the plan is in place.

If you are staying in the hospital you can ask your healthcare team about the ReSPECT process. The hospital team will have a ReSPECT conversation with you if they think it would benefit you.

No. ReSPECT recommendations are to guide immediate decision-making by health and care professionals responding to the person in a crisis. However, they should be able to give valid reasons for overriding recommendations on a ReSPECT plan.

If you would also like to make a plan that is legally binding, you could make an Advance Decision to Refuse Treatment (ADRT). This isn’t something you can do with your healthcare team in the hospital. If you would like to find out more about ADRTs, visit https://www.nhs.uk/conditions/end-of-life-care/planning-ahead/advance-decision-to-refuse-treatment.

• ·         Any member of your healthcare team including your GP
• ·         Those closest to you
• ·         A chaplain from our Multifaith Department of Spiritual and Pastoral Care
• ·         Your own spiritual adviser
• ·         Patient support organisations such as Age UK, Macmillan Cancer Support and other condition specific charities
• ·         Dying Matters - let’s talk about it www.dyingmatters.org/
• ·         Independent advocacy services. An advocacy service can help you express your views or make your own decisions, or can speak on your behalf.

• Guidance from the British Medical Association (BMA), the Resuscitation Council (UK), and the Royal College of Nursing (RCN) can be found at:  www.resus.org.uk/dnacpr/decisions-relating-to-cpr/ 
• Advance Decision to Refuse Treatment:  https://www.nhs.uk/conditions/end-of-life-care/advance-decision-to-refuse-treatment/ 
• Lasting Power of Attorney - Health and Welfare: www.gov.uk/ government/organisations/office-of-the-public-guardian 
• ReSPECT: https://www.resus.org.uk/respect 
• Dying isn’t as bad as you think – a BBC video with palliative care consultant Dr Kathryn Mannix https://youtu.be/CruBRZh8quc