ReSpect Care Plan

ReSPECT (Recommended Summary Plan for Emergency Care and Treatment) is a process of creating a personalised plan of care for someone’s clinical needs in an emergency situations where they are not able to make decisions or express their own wishes.

Key objectives

To provide patients with a digital version of the ReSpect plan, giving healthcare professionals access to their wishes and making sure emergency teams know them at the point of care.

Outcome measures

Equip patients with the tools they need to document and share their wishes for treatment, to support difficult conversations and support self-management of complex health conditions, as well as providing the tools they need to interact digitally rather than relying on a face to face consultations.

Current Baselines

Paper base document that is accessible in emergency situations, meaning patients wishes are followed.

Workflow

Patient: Record created and invited to register
Patient: Claims their PKB record
GP practice: Add carer to patient's record
Carer: Claims their patient PKB record. Ability to view the relatives/friends record as a carer
Patient: Attends appointment with GP
GP: Views patients PKB record
GP: Adds and completes care plan with patient wishes
Carer/Patient: Ability to change care plan
PKB: Displaces audit trail of any changes to the ReSpect care plan
Patient/carer: Uses care plan to view wishes and share in emergency situations
Emergency teams: Has the ability to view patients care plan

ReSpect Care Plan Template

Example care plan template code for ReSpect Care Plan HTML

.form-group {width: 100%; !important}

.cp_separator {height: 3px; background-color: #54496f;; margin-top: 5px; margin-bottom: 5px;}

.row-eq-height {display: -webkit-box;display: -webkit-flex;display: -ms-flexbox;display: flex; text-align: center;}

</style>

<h2>2. Summary of relevant information for this plan <a href="#section6">(see also section 6)</a></h2>

<label for="cp_relevantInfo_1">Including diagnosis, communication needs (e.g. interpreter, communication aids) and reasons for the preferences and recommendations recorded.</label>

</div>

<label for="cp_relevantInfo_2">Details of other relevant planning documents and where to find them (e.g. Advance Decision to Refuse Treatment, Advance Care Plan). Also include known wishes about organ donation.</label>

</div>

<h2>3. Personal preferences to guide this plan (when the person has capacity)</h2>

<input class="form-check-input" type="radio" name="cp_preference" id="inlineRadio1" value="0 - Prioritise sustaining life, even at the expense of some comfort"> 0 - Prioritise sustaining life, even at the expense of some comfort</input>

</div>

</div>

</div>

</div>

</div>

</div>

</div>

</div>

</div>

</div>

<input class="form-check-input" type="radio" name="cp_preference" id="inlineRadio1" value="10 - Prioritise comfort, even at the expense of sustaining life"> 10 - Prioritise comfort, even at the expense of sustaining life</input>

</div>

<label for="cp_mostImportant"><h3>Considering the above priorities, what is most important to you is (optional):</h3></label>

</div>

<h2 style="color: #ffffff;">4. Clinical recommendations for emergency care and treatment</h2>

<label for="cp_focusLifeSustaining"><h3>Focus on life-sustaining treatment as per guidance below</h3></label>

</div>

<label for="cp_focusSymptomControl"><h3>Focus on symptom control as per guidance below</h3></label>

</div>

<label for="cp_clinicalGuidence"><h3>Now provide clinical guidance on specific interventions that may or may not be wanted or clinically appropriate, including being taken or admitted to hospital +/- receiving life support:</h3></label>

</div>

<label for="cp_cprAttemptsRecomended"><h3>CPR attempts recommended Adult or child</h3></label>

</div>

<label for="cp_modifiedCPRChild" style="background-color: #897ab8"><h3 style="color:#ffffff">For modified CPR <b>Child only, as detailed above</b></h3></label>

</div>

<label for="cp_cprAttemptsRecomended2"><h3>CPR attempts <b>NOT</b> recommended Adult or child</h3></label>

</div>

<h2 style="color: #ffffff;">5. Capacity and representation at time of completion</h2>

<label for="cp_sufficentCapacity"><h3>Does the person have sufficient capacity to participate in making the recommendations on this plan?</h3></label>

</div>

</div>

</div>

<label for="cp_sufficentCapacity"><h3>Do they have a legal proxy (e.g. welfare attorney, person with parental responsibility) who can participate on their behalf in making the recommendations? If so, document details in emergency contact section below</h3></label>

</div>

</div>

</div>

<input class="form-check-input" type="radio" name="cp_sufficentCapacity" id="cp_sufficentCapacityYes" value="Unknown" style="padding-left: 15px;"> Unknown</input>

</div>

<h2 style="color: #ffffff;" id="section6">6. Involvement in making this plan</h2>

<h3>The clinician(s) signing this plan is/are confirming that (select A,B or C, OR complete section D below):</h3>

<input class="form-check-input" type="checkbox" value="A This person has the mental capacity to participate in making these recommendations. They have been fully involved in making this plan." id="cp_6a" name="cp_6a"> A This person has the mental capacity to participate in making these recommendations. They have been fully involved in making this plan.</input>

</div>

<input class="form-check-input" type="checkbox" value="B This person does not have the mental capacity to participate in making these recommendations. This plan has been made in accordance with capacity law, including, where applicable, in consultation with their legal proxy, or where no proxy, with relevant family members/friends." id="cp_6b" name="cp_6b"> B This person does not have the mental capacity to participate in making these recommendations. This plan has been made in accordance with capacity law, including, where applicable, in consultation with their legal proxy, or where no proxy, with relevant family members/friends.</input>

</div>

<input class="form-check-input" type="checkbox" value="C This person is less than 18 (UK except Scotland) / 16 (Scotland) years old and (please select 1 or 2, and also 3 as applicable or explain in section D below):" id="cp_6c" name="cp_6c"> C This person is less than 18 (UK except Scotland) / 16 (Scotland) years old and (please select 1 or 2, and also 3 as applicable or explain in section D below):</input>

</div>

<input class="form-check-input" type="checkbox" style="margin-left: 15px;" value="1 They have sufficient maturity and understanding to participate in making this plan" id="cp_61" name="cp_61"> 1 They have sufficient maturity and understanding to participate in making this plan</input>

</div>

<input class="form-check-input" type="checkbox" style="margin-left: 15px;" value="2 They do not have sufficient maturity and understanding to participate in this plan. Their views, when known, have been taken into account." id="cp_6c2" name="cp_6c2"> 2 They do not have sufficient maturity and understanding to participate in this plan. Their views, when known, have been taken into account.</input>

</div>

<input class="form-check-input" type="checkbox" style="margin-left: 15px;" value="3 Those holding parental responsibility have been fully involved in discussing and making this plan." id="cp_6c3" name="cp_6c3"> 3 Those holding parental responsibility have been fully involved in discussing and making this plan.</input>

</div>

<label for="cp_6d">D If no other option has been selected, valid reasons must be stated here. Document full explanation in the clinical record.</label>

</div>

<label for="cp_rolesDiscussions"><h3>Record date, names and roles of those involved in decision making, and where records of discussions can be found:</h3></label>

</div>

<h2 style="color: #ffffff;">7. Clinicians' signatures</h2>

<h3>Designation (grade/speciality)</h3>

</div>

<h3>Clinician name </h3>

</div>

<h3>GMC/NMC/HCPC Number</h3>

</div>

</div>

<h3 class="hidden-lg hidden-md hidden-sm">Designation (grade/speciality)</h3>

</div>

<h3 class="hidden-lg hidden-md hidden-sm">Clinician name </h3>

</div>

<h3 class="hidden-lg hidden-md hidden-sm">GMC/NMC/HCPC Number</h3>

</div>

</div>

<h3 class="hidden-lg hidden-md hidden-sm">Designation (grade/speciality)</h3>

</div>

<h3 class="hidden-lg hidden-md hidden-sm">Clinician name </h3>

</div>

<h3 class="hidden-lg hidden-md hidden-sm">GMC/NMC/HCPC Number</h3>

</div>

</div>

<h3 class="hidden-lg hidden-md hidden-sm">Designation (grade/speciality)</h3>

</div>

<h3 class="hidden-lg hidden-md hidden-sm">Clinician name </h3>

</div>

<h3 class="hidden-lg hidden-md hidden-sm">GMC/NMC/HCPC Number</h3>

</div>

</div>

<p style="color: #ffffff;">Senior responsible clinician</p>

</div>

<h2 style="color: #ffffff;">8. Emergency contacts</h2>

</div>

</div>

<h3>Telephone</h3>

</div>

<h3>Other details</h3>

</div>

<p>Legal proxy/parent</p>

</div>

</div>

<h3 class="hidden-lg hidden-md hidden-sm">Telephone</h3>

</div>

<h3 class="hidden-lg hidden-md hidden-sm">Other details</h3>

</div>

<p>Family/friend/other</p>

</div>

</div>

<h3 class="hidden-lg hidden-md hidden-sm">Telephone</h3>

</div>

<h3 class="hidden-lg hidden-md hidden-sm">Other details</h3>

</div>

</div>

</div>

<h3 class="hidden-lg hidden-md hidden-sm">Telephone</h3>

</div>

<h3 class="hidden-lg hidden-md hidden-sm">Other details</h3>

</div>

<p>Lead Consultant</p>

</div>

</div>

<h3 class="hidden-lg hidden-md hidden-sm">Telephone</h3>

</div>

<h3 class="hidden-lg hidden-md hidden-sm">Other details</h3>

</div>

<h2 style="color: #ffffff;">9. Confirmation of validity (e.g. for change of condition)</h2>

<h3>Review date</h3>

</div>

<h3>Designation (grade/speciality)</h3>

</div>

<h3>Clinician name </h3>

</div>

<h3>GMC/NMC/HCPC number </h3>

</div>

<h3 class="hidden-lg hidden-md hidden-sm">Review date</h3>

</div>

<h3 class="hidden-lg hidden-md hidden-sm">Designation (grade/speciality)</h3>

</div>

<h3 class="hidden-lg hidden-md hidden-sm">Clinician name </h3>

</div>

<h3 class="hidden-lg hidden-md hidden-sm">GMC/NMC/HCPC number </h3>

</div>

<h3 class="hidden-lg hidden-md hidden-sm">Review date</h3>

</div>

<h3 class="hidden-lg hidden-md hidden-sm">Designation (grade/speciality)</h3>

</div>

<h3 class="hidden-lg hidden-md hidden-sm">Clinician name </h3>

</div>

<h3 class="hidden-lg hidden-md hidden-sm">GMC/NMC/HCPC number </h3>

</div>

Further information:

Access a patient record in an emergency (Break the glass access): How A&E staff can view a patients PKB record in an emergency
Access log: Within a patients PKB record, there is the ability to see who is viewing your PKB record