Should Wessex implement ReSPECT process? – The NIHR CLAHRC Wessex hosted event May 11, 2017

The event in Southampton attracted organisations* from across the Wessex region and beyond and a wide range of people including the public, paramedics, nursing staff, clinicians, managers and researchers.

Many stakeholders were represented bringing together 44 delegates, all there to examine and reflect on whether the ReSPECT approach to decision making for emergency care should be adopted.

ReSPECT stands for the Recommended Summary Plan for Emergency Care and Treatment.

It is defined by those behind its development as a “process that creates personalised recommendations for a person’s clinical care in a future emergency in which they are unable to make or express choices. It provides health and care professionals responding to that emergency with a summary of recommendations to help them to make immediate decisions about that person’s care and treatment. ReSPECT can be complementary to a wider process of advance/anticipatory care planning”

During the careful development process feedback from stakeholders, including patients was used to design and modify the form, which is recognisable from its purple design.

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The NIHR CLAHRC Wessex hosted event was just one of a number organised to hear feedback and reaction to the ReSPECT process and to discuss what barriers may exist in implementing it across the full range of health care environments.

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Catherine Baldock (pictured above), Head of Resuscitation, Clinical Skills and Simulation at University Hospitals Coventry and Warwickshire NHS Trust, presented her experience as an early adopter (and part of an NIHR funded evaluation) of ReSPECT. During her presentation, she spoke of some of the problems she came up against, but also of significant positive support from patients and the healthcare community for the process once implemented.

Following the lively debate and discussion on the day Catherine reflected,

“People will always look for problems and reasons not to adopt and yet I would urge them to look for solutions and the benefits of implementing this. It does put the patient in the centre of the decision making process and empowers them to be able to discuss what they would like and what they see as their priorities of care.”

There were further presentations from different sectors represented at the event, some group work to capture key issues for consideration, and there was also time for questions and discussion.

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Professor Alison Richardson, has been working with her research team at NIHR CLAHRC Wessex to examine the development and implementation of Treatment Escalation Plans, and fed learning into early versions of ReSPECT.

“It was clear from the meeting that there is strong support for the principles embedded in the ReSPECT process.  But given the different processes already in use and initiatives underway or planned in our region there is a clear need for organisations to decide where and how best to test ReSPECT and work through the best means to address a central issue – that  of transfer of information across sectors.  We heard from a patient point of view they want us to get on with it, as adopting a unified approach with the potential to cross the gaps – in teams, across teams, from home to hospital and hospital to home, involving the 111 and 999 services and care homes – is really important to them.”

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Sally Dace is a champion for patient and public involvement for CLAHRC Wessex, and was there at the event to record feedback from the stakeholder groups. She believes there is one straightforward test for ReSPECT

“At the end of the day the success of the process will be how many patients are willing to embrace it, rather than how the form looks, how good the computer systems are or how engaged professionals are.”

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“It was great to see so much energy in the room. Few if any things have ever come without challenges, but what needs to drive us forward is improving patient outcomes and patient experience – and if something is worth doing, together we will make it work.” – Frederico Moscogiuri, Chief Executive of the Resuscitation Council

The organisers of the event (NIHR CLAHRC Wessex) are now gathering anonymous feedback through an online survey, which will be pulled together and shared with those who came to the event. We look forward to seeing how the region and individual organisations within it respond going forward.

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If you want any more information about our work with TEPs or ReSPECT contact: s.bogle@soton.ac.uk or go to the website

The presentations are available here:

*Below is a full list of the organisations represented.

Dorset County Hospital NHS Foundation Trust

Dorset Healthcare University NHS Foundation Trust

Hampshire Hospitals NHS Foundation Trust

Isle of Wight NHS Trust

Macmillan

NHS England South (Wessex)

NIHR Wessex CLAHRC

Oakhaven Hospice

Oxford Health NHS Foundation Trust

Poole Hospital NHS Foundation Trust

Portsmouth Hospitals NHS Trust

Resuscitation Council (UK)

Rowan’s Hospice

Salisbury NHS Foundation Trust

Solent NHS Trust

South Central Ambulance Service NHS Foundation Trust

South Western Ambulance Service NHS Foundation Trust

Southern Health NHS Foundation Trust

Stoneham Lane Surgery

The Bridges & Dorchester Road Surgeries Weymouth & Portland Locality

University Hospital Southampton NHS Foundation Trust

University Hospitals Coventry and Warwickshire NHS Trust

University of Southampton

Wessex Academic Health Science Network

Wessex Clinical Strategic Network

Weymouth Elderly Care Service, Two Harbours GP Federation

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