What is 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 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 or not CPR should be attempted if the person’s heart and breathing stop.

How does it 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 plan.

What is a ReSPECT conversation?

ReSPECT conversations follow the ReSPECT process by:

  1. discussing and reaching a shared understanding of the person’s current state of health and how it may change in the foreseeable future,
  2. identifying what is important to the person in relation to goals of care in the event of a future emergency,
  3. using that to record an agreed focus of care (either more towards life-sustaining treatments or more towards prioritising comfort over efforts to sustain life),
  4. making and recording shared recommendations about specific types of care and realistic treatment that should/shouldn’t be given, and explaining sensitively recommendations about treatments that would clearly not work int their situation
  5. making and recording a shared recommendation about whether or not CPR is recommended.