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ReSPECT

ReSPECT stands for Recommended Summary Plan for Emergency Care and Treatment. The ReSPECT process creates a summary of personalised recommendations for a person’s clinical care in a future emergency in which they do not have the capacity to make or express choices. Such emergencies may include death or cardiac arrest but are not limited to those events. The process is intended to respect both patient preferences and clinical judgement. The agreed realistic clinical recommendations that are recorded include a recommendation on whether CPR should be attempted if the person’s heart and breathing stop.

ReSPECT is a nationally supported process which has been developed by the Resuscitation Council alongside key stakeholders including the Royal Colleges. It has already been successfully implemented in many NHS trusts.

How does ReSPECT work?

The ReSPECT plan is created through conversations between a patient and one or more of their healthcare professionals who are involved with their care.

The plan should stay with the person and be available immediately to those faced with making immediate decisions in an emergency in which the person themselves has lost the capacity to participate in making said decisions.

ReSPECT may be used across a range of health and care settings, including the person’s own home, an ambulance, a care home, a hospice, or a hospital. Professionals such as ambulance crews, out-of-hours doctors, care home staff and hospital staff will be better able to make immediate decisions about a person’s emergency care and treatment if they have prompt access to agreed clinical recommendations on a ReSPECT form.

What is a ReSPECT conversation?

A ReSPECT conversation follows the ReSPECT process by:

  • Discussing and reaching a shared understanding of the person’s current state of health and how it may change in the foreseeable future
  • Identifying the person’s preferences for and goals of care in the event of a future emergency
  • Using that to record an agreed focus of care as being more towards life-sustaining treatments or more towards prioritising comfort rather than efforts to sustain life
  • Making and recording shared decisions about specific types of care and realistic treatment that they would want to be considered, or that they would not want, and explaining sensitively advanced decisions about treatments that clearly would not work in their situation
  • Making and recording a shared decision about whether CPR is recommended.

Patient Information