THE final wishes of patients at York Hospital over whether they should be resuscitated in the event of an emergency have not been recorded correctly, according to a recent inspection.

The Care Quality Commission (CQC) has given the hospital 28 days to make improvements after inspectors raised serious concerns over the way “do not attempt resuscitation” (DNAR) forms were completed by staff.

While the report made it clear that patients were happy with information over what care they would receive, including DNAR details, the CQC said decisions over resuscitation were not subsequently being recorded properly.

Jo Dent, regional director of CQC for Yorkshire and Humber, said: “Very often these forms are completed when a patient is admitted to hospital, perhaps in a critical condition – but the decisions which are made then must be reviewed as a priority if a person’s condition improves or stabilises. We found DNAR forms which had been completed by a doctor, but that there was no evidence to say that patients had been involved in the decision, or evidence that relatives, even where they were taking an active role in the patient’s progress, had been consulted.”

The report added: “The trust’s own policies are in place and make it clear how these decisions are to be reached, who to consult and how it should be recorded to make sure the right decision is made. The records seen by us did not follow these guidelines.”

The CQC also raised concerns over the management of medicine in some areas and the meeting of certain patients’ nutritional needs.

Katherine Murphy, chief executive of the Patients’ Association said, “It is disgraceful that patients’ lives are being treated so casually.”

She said: “There need to be regular reviews of the DNAR order as the patient’s condition changes. The CQC must take any step necessary to prevent this dreadful and distressing situation from recurring.”

Patrick Crowley, chief executive at York Teaching Hospital NHS Foundation Trust, said: “All professionals within our organisation recognise the importance and sensitivity of discussions with patients and their families regarding DNAR decisions. What the CQC found was a lack of documentation to demonstrate where this was happening, and some variation in practice between doctors.

“We are aware of individual cases where patients and relatives have understandably found this difficult, and we are sorry if this has caused any unnecessary distress. We want to listen to this feedback to help us to develop our processes and ensure that we demonstrate that we are acting in patients’ best interests. It is important to recognise that a new system was introduced not long before the CQC’s visit, and we are in the process of rolling it out across the organisation.”

He said the hospital was commended in the report for its care and helpful staff, with doctors and nurses “going out of their way to inform patients of the care they would receive”.