A major charity has written to Scotland’s healthcare oversight body calling for an investigation into the use of Do Not Attempt Cardio-Pulmonary Resuscitation orders (DNACPRs) during the covid-19 crisis.

Today’s letter to Healthcare Improvement Scotland comes after a damning report was published by England’s care watchdog into the use and practice of DNACPRs south of the border.

The Care Quality Commission in England found the human rights of more than 500 patients may have been breached when DNACPR orders were imposed without discussion with the person or their families.

Age Scotland says it has received reports from older people and their families who received calls from their GPs asking them to agree to a DNACPR, as well as patients who discovered completed paperwork has been included in their hospital discharge notes without their knowledge.

A Scottish government spokeswoman said there had been "absolutely no change" to the use of DNACPR forms in Scotland and that clear guidance had been in place since the start of the pandemic.

But Age Scotland Chief Executive Brian Sloan said he was aware of “numerous examples” of the forms being put in place potentially inappropriately.

He said: "We know from calls to our helpline that a number of older people and their families in Scotland have been very concerned and angry about the way DNACPR decisions were applied to them in the past year.

"We heard from over 60s who considered themselves to be in good health receiving an unexpected call from the GP asking them to agree not to receive medical intervention if their heart stopped beating or their breathing stopped.

“They were suspicious that they were targeted simply because of their age and left feeling that their lives were less valued.

He added: "We heard from families of care home residents who were upset to learn that their loved one was now covered by a DNACPR without any consultation and from people who discovered the completed forms in their hospital discharge notes, with no knowledge of having agreed to it.

"There are considerable questions about whether individual human rights were breached when DNACPR decisions were made without discussion or knowledge.”

Mr Sloan added: "We believe there are numerous examples of the same thing happening here in Scotland, which is why we are calling on Healthcare Improvement Scotland to conduct its own investigation, as their counterparts in England have.

"We want to know exactly what happened, how many people had DNACPR decisions made without their knowledge and whether there was a criterion for people approached, such as age or shielding status.

"DNACPRs have an important place in anticipatory care planning but it appears that the correct procedures and appropriate conversations were not happening, giving older people the impression they had been cast aside without being given a fighting chance.

"This issue understandably has caused a great deal of alarm and upset to older people and their families, during what was already an extremely challenging time, and that is unacceptable.

"It is now vital that older people and their families get cast-iron guarantees that this practice is applied correctly and with compassion going forward."

The Scottish government has said it will carry out a full public inquiry into all aspects of the pandemic but as yet has given no dates for that work.

Pressure from opposition politicians for an inquiry into what happened in Scotland’s care homes after the first lockdown were rebuffed. The government did however commission a review of adult social care, which was not charged with looking at the impact of the pandemic specifically and concluded ministers should have been in charge of social care.

A Scottish government spokeswoman said: “No one should ever feel pressured in any way whatsoever when discussing treatment options – and the covid-19 pandemic has brought about absolutely no change to the use of Do Not Attempt CPR forms in NHS Scotland, and no change to the advice issued to clinicians about their use.”

Read more: Watchdog finds DNRs kept secret from families; Clearer DNR advise pledged after virus controversy; Older people’s care decisions made without their input

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