What is ReSPECT?

The ReSPECT (Recommended Summary Plan for Emergency Care and Treatment) process creates a summary of personalised recommendations for a person’s clinical care in a future emergency in which they do not have capacity to make or express choices. Such emergencies may include people who are likely to be nearing the end of their lives, and/or people who are at risk of sudden deterioration or cardiac arrest, although ReSPECT is 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 cardiopulmonary resuscitation (known as CPR) should be attempted if the person’s heart and breathing stop.

Read more about ReSPECT, and access free resources, on the Resuscitation Council website.

How does the ReSPECT process work?

The plan is created through conversations between a person and one or more of the health professionals who are involved with their care. The plan should stay with the person and be available immediately to health and care professionals faced with making immediate decisions in an emergency in which the person themselves has lost capacity to participate in making those 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.

It will also record a Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decision, or a Treatment Escalation Plan if one has been made. However, ReSPECT is about much wider care preferences and treatment ceilings and is equally applicable to patients for whom resuscitation is appropriate.

ReSPECT has been developed by the Resuscitation Council, working alongside stakeholders from across NHS services. The ReSPECT process is increasingly being adopted within health and care communities around the UK, in the place of multiple different Treatment Escalation Plans and DNACPR forms.

Watch this video from Catherine Baldock, Clinical Lead for ReSPECT at the Resuscitation Council, to learn more about the ReSPECT process.

Why do we need ReSPECT?

“Empowering people to make informed decisions about their care is an essential part of a person-centred approach to healthcare and nowhere is this more important than in decisions about life and death. The ReSPECT process was developed to help ensure that these decisions are made correctly, and as far as possible in accordance with a person’s own wishes. We believe this will improve the quality of care and lead to a culture shift with emergency and end of life care.” — Federico Moscogiuri, Chief Executive, Resuscitation Council (UK).

Too few of our most frail and complex patients have advance care plans that describe what should happen in an emergency. This means that clinicians and carers must make decisions about a person’s best interests and preferences and some very frail patients are resuscitated when they would not wish to be. Many people are also taken to hospital in an emergency when they would have preferred to stay at home. They often recover much more slowly in hospital than they would have in more familiar surroundings.

Ensuring there are high-quality advance care plans, accessible to the clinicians who need them, enables better care for patients, peace of mind for their carers and greater satisfaction for staff who can be confident they are following their patients’ wishes.

The roll-out of ReSPECT in the West of England was one part of a national Patient Safety Collaborative strategy to improve the care of patients at risk of deterioration.

ReSPECT was implemented in BNSSG and Gloucestershire systems at the end of 2019, and is now well embedded in services across both regions, with BSW system implementing ReSPECT from October 2021.

Read a blog – written in November 2020 by Anne Pullyblank, Health Innovation West of England’s Medical Director – reflecting on, and celebrating the success of the ReSPECT programme.

Anne discusses how ReSPECT started, the success of the programme, and what’s next.

Find out more about the impacts of the project in our ReSPECT case study.

Journey of a ReSPECT form

We have worked with the Resuscitation Council UK to produce two animations, one for patients and the public and one for healthcare professionals, telling the story of Joe and how his ReSPECT form improved communication and coordinated personalised, individualised care across the health and care system.

Animation for healthcare professionals

Watch the ReSPECT animation for healthcare professionals here.

Animation for patients and the public

Watch the ReSPECT animation for patients and the public here.

Our ReSPECT Events

If you are an organisation implementing ReSPECT in the West of England, visit our ‘Implementing ReSPECT’ page for further resources or please get in touch.

If you are an organisation implementing ReSPECT outside of the West of England, contact the Resuscitation Council directly.

If you are a patient or carer looking for more information about ReSPECT, visit the Resuscitation Council website.


Implementing ReSPECT as a healthcare professional

Training for staff who will need to recognise the ReSPECT form, act on recommendations and be initiating or carrying out conversations with patients and their families about treatment escalation, DNACPR, and the ReSPECT process.

Read more