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Description
In this episode of CQC Connect, the podcast from the Care Quality Commission, we're joined by Rosie Benneyworth, Chief Inspector of Primary Medical Services and Integrated Care and Usha Grieve, Director of Partnerships and Services at Compassion in Dying to explore CQC’s latest report called Protect, respect, connect – decisions about living and dying well during COVID-19. This is CQC’s review of ‘do not attempt cardiopulmonary resuscitation’ decisions during the COVID-19 pandemic.
You can read the full report on our website: https://www.cqc.org.uk/publications/themed-work/protect-respect-connect-decisions-about-living-dying-well-during-covid-19
You can find Rosie's blog on our medium page: https://carequalitycomm.medium.com/protect-respect-connect-its-time-to-talk-about-end-of-life-care-planning-98837e3db91d
Listen to more podcasts from the CQC: https://soundcloud.com/carequalitycommission
Find out more information about the CQC and how it regulates health and social care in England: https://www.cqc.org.uk/
A
B
B
I've
led
on
the
development
and
delivery
of
this
review,
since
it
was
commissioned
by
the
department
of
health
and
social
care
back
in
october,
2020
we're
going
to
spend
time
discussing
the
report,
its
findings
and
what
the
recommendations
mean
for
you,
I'm
very
pleased
to
be
joined
by
my
colleague,
rosie
bennywood,
chief
inspector
of
primary
medical
services
and
integrated
care,
and
also
I'd
like
to
welcome
usha,
grieve
director
of
partnerships
and
services
at
compassion
in
dying.
A
very
warm
welcome
to
you.
Both
you've
both
played
an
active
role
in
this
reviews
journey.
B
C
Hi
victoria,
I'm
rosie
bennyworth,
I'm
the
chief
inspector
of
primary
medical
services
and
integrated
care
at
the
cqc.
This
review
is
really
important
to
me.
It's
vital
that
we
ensure
that
people
are
able
to
make
decisions,
informed
decisions
about
their
health
and
care
and
they're
able
to
feel
empowered
to
do
that
in
a
way
that
they
feel
that
they've
got
the
information
to
be
able
to
do
that.
C
D
Thanks
victoria
so
yeah
my
name's
usha,
and
I
work
for
compassion
in
dying
and
we're
a
national
charity
that
supports
people
to
make
decisions
and
plan
their
end
of
life
care
and
dna.
Cpr
decision
making
has
just
such
a
massive
impact
on
the
people
that
we
support
and
that's
both
in
terms
of
their
quality
of
life
in
the
present
and
also
the
end
of
life.
D
Experience
that
both
they
and
their
family
members
have,
and-
and
we
hear
about
this
from
all
end
of
the
spectrum
so
from
the
positive
impact
that
having
a
do
not
resuscitate
form,
can
can
have
to
the
the
negative
impact
that
happens
when
they're
communicated
badly.
So
I'm
hugely
passionate
really
about
getting
this
right.
Thank.
C
So
as
a
result
of
that,
we
were
commissioned
by
the
department
to
undertake
the
department
of
health
and
social
care
to
undertake
this
review.
I
think
what
we've
learned
through
the
review
is
that
these
problems
and
these
issues
with
dna
cpr
have
been
long-standing.
They
predate
the
pandemic,
but
I
think
the
pandemic
has
exposed
them
to
a
greater
degree.
C
We've
seen
issues.
We
have
heard
a
lot
of
good
practice,
which
is
fantastic,
and
we
have
shared
that
in
our
report
and
it's
really
important
to
that.
A
lot
of
people
have
good
discussions
and
we
want
to
learn
from
what
happens
in
those
good
discussions
and
encourage
all
areas
to
look
at
how
they
can
embed
that
good
practice.
C
B
Great
thank
you
rosie,
so
recognizing
that
these
issues
predate
the
pandemic
and
also
the
significance
of
the
reviews.
Findings.
There
are
a
number
of
recommendations
included
to
the
report,
which
I
encourage
all
podcast
listeners
to
read.
But
rosie,
would
you
be
able
to
share
an
overview
of
those
recommendations.
C
Yes,
certainly,
we've
set
out
a
comprehensive
set
of
recommendations,
starting
with
the
need
for
a
ministerial
oversight
group
to
understand
the
issues
that
we've
raised
in
our
report
in
more
detail
and
then
to
make
sure
that
these
are
taken
forward.
We've
then
set
out
our
recommendations
in
three
areas:
firstly,
around
information,
training
and
support,
and
we
want
to
make
sure
that
providers
make
sure
that
they're
the
clinicians
ensure
that
people
are
involved.
C
The
final
recommendation
in
this
section
is
around
how
we
make
sure
that
there's
clear,
consistent
training
standards
and
guidance
for
people
across
all
sectors,
we
then
move
on
to
a
series
of
recommendations
around
a
consistent
national
approach
to
advanced
care
planning.
Firstly,
we
are
calling
for
a
national
campaign
to
ensure
that
people
understand
what
good
looks
like
around
dna
cpr
and
that
they
are
informed
about
what
they
should
expect
and
there
should
be
a
positive
promotion
around
having
these
conversations
as
part
of
a
broader
advanced
care
planning
conversation.
C
Secondly,
we
want
to
make
sure
that
there
are
consistent
national
tools
around
policy
guidance
and
tools
that
everyone
can
follow
to
allow
that
consistent
approach
right
across
the
country.
And
thirdly,
we
want
to
make
sure
that
information
is
shared
in
a
timely
way
and
we
think
that
to
do
that,
there
needs
to
be
better
a
digital
compatibility
between
all
systems
in
local
areas.
The
final
area
of
recommendations
is
around
improved
oversight
and
assurance.
C
The
first
recommendation
here
is
to
make
sure
that
records
are
comprehensive
and
that
their
standards
of
records
and
documentation
that
the
providers
ensure
are
kept
to.
Secondly,
we
want
to
make
sure
that
there's
a
consistent
data
set
and
metrics
that
integrated
care
systems
look
at,
and
then
we've
asked
the
national
guardians
office
to
lead
on
the
the
third
recommendation
in
this
section,
which
is
about
how
do
we
support
people
to
speak
up
about
any
concerns
they
have
about
dna
cpr
and
to
raise
those
concerns
and
make
sure
they're
listened
to
and
acted
upon?
C
Finally,
the
last
recommendation
is
for
the
cqc
as
an
organization
to
make
sure
that
we
continue
to
seek
assurance
that
people
are
at
the
center
of
these
decisions
and
we
will
contin
ensure
a
continued
focus
on
our
dna
cpr
decisions
through
our
monitoring
assessment
and
inspection
of
all
health
and
adult
social
care
providers.
Thank
you.
Rosie.
B
D
D
C
These
are
really
important
factors
and
we
need
to
make
sure
that
these
are
not
snatched
conversations
on
on
the
edge
of
a
ward
round
and
or
these
are
not.
These
are
not
things
that
just
happen
on
the
end
of
a
phone
out
of
the
blue.
These
are
important
conversations.
We
need
to
make
sure
they
happen
at
an
early
stage,
and
we
need
to
encourage
people
to
to
start
the
conversation
if
they
feel
ready
to
have
it.
B
And
to
flag
for
listeners,
our
report
does
contain
examples
of
where
we
found
and
what
good
practice
looks
like,
and
it's
really
important
for
us
to
share
those.
So
I
would
encourage
all
to
read
and
look
for
those
examples.
Compassioning
dying
signed
a
joint
statement
with
many
other
partners
usher.
Could
you
tell
us
a
bit
more
about
that
sure.
D
So
the
the
statement
was
really
in
response
to
some
media
coverage
around
dna
cpr
decision
making,
which
at
one
point
was
perhaps
only
telling
one
side
of
the
story,
and
we
really
wanted
to
make
sure
that
you
know
in
in.
In
line
with
what
rosie
was
just
saying
about
the
importance
of
good
quality.
End-Of-Life
conversations.
B
D
The
main
thing
that
we
found
was
that
there
is
a
huge
range
of
experiences
when
it
comes
to
dna,
cpr
decision
making
and
communication,
which
I
know
is
echoed
in
the
cqc's
report
as
well,
and
we
realized
that
compassion
in
dying
several
years
ago
that
do
not
attempt
cpr
was
a
recurring
theme
in
calls
to
our
information
line.
But
when
the
pandemic
began,
the
proportion
of
calls
on
that
topic
actually
doubled.
So
we
analyzed
called
over
that.
D
I
think
it
was
a
full
year
period
and
it
was
really
clear
that
poor
or
non-existent
communication
created
so
much
anxiety
and
distress
for
people
and
families.
You
know
it
really
does
leave
a
trail
of
devastation
for
many
people
and
that's
a
legacy
that
lives
on
in
a
family
long
after
someone
has
died.
D
But
what
was
really
interesting
in
the
conversations
that
we
were
having
with
people
was
that
for
the
people
that
we
were
speaking
to
often
you
know
when
somebody
experienced
distress
about
a
dna
cpr
decision
that
distress
was
caused
by
the
poor
communication
and
not
the
decision
itself.
So
you
know
people
would
call
us
really
upset,
because
they'd
found
a
dna
cpr
form
in
a
family
member's
discharge
notes
and
they
were
really
shocked
and
they
didn't
know
what
it
mean.
Didn't
know
what
it
meant
and
they
didn't
know
what
they
should
do.
D
D
So
lots
of
people
in
the
uk
feel
strongly
that
cpr
would
not
be
right
for
them
and
they
want
to
do
something
about
this
and
they
told
us
that
having
a
dna,
cpr
form
gives
them
peace
of
mind
and
then
the
other
thing.
If
I
may,
I
think
that's
really
interesting
and
important
to
kind
of
bear
in
mind
as
we're
thinking
about
moving
forwards
and
improving
practice
kind
of
now
and
beyond.
D
C
C
C
If
we,
if
we
haven't,
been
able
to
gain
assurance
that
the
providers
are
dealing
with
that
appropriately
and
we
outlined
in
our
interview
report
last
year,
how
important
it
was
for
providers
to
get
that
assurance
themselves
that
all
dna
cpr
decisions
are
appropriate.
Then,
if
we
haven't
been
able
to
get
that
assurance
ourselves,
then
we
will
inspect
providers
and
we
will
see
what
they
are
doing
and
we
will
take
any
action.
C
We
need
to
to
ensure
that
blanket
any
form
of
blanket
dna
cpr
approach
is
stopped
and
we
we
need
to
also
make
sure
that
the
quality
of
these
dna
cpr
decisions
are
as
good
as
possible.
So
we
will.
We
will
encourage
the
providers
to
look
at
what
they
are
doing
and
how
they
can
improve
their
processes.
C
The
final
thing
just
to
mention
is
that
we
are
looking
at
this
through
our
inspection
framework
and
our
assessment
framework,
and
we
are
training
our
inspectors
to
know
how
to
ask
about
this
and
and
what
to
look
for.
So
we
are
undergoing
on
ongoing
work
around
this
area
and
we
will
continue
to
make
sure
that
we-
what
we
do
leads
to
the
improvements
in
the
system
that
we
soon
desperately
need
to.
B
D
I
completely
agree
with
the
cqc's
recommendations
about
a
public
awareness
campaign.
I
think
we
really
need
to
encourage
people
to
think
about
and
discuss
cpr
and
other
treatment
wishes,
and
these
conversations
you
know
they
need
to
happen
as
early
as
possible.
You
know
not
just
passed
along
the
next
clinician
in
line
until
it's
so
late
in
that
person's
healthcare
journey,
that
you
know
they,
they
can't
participate
in
decisions
or
there
isn't
time
for
it
to
kind
of
be
thought
through
or
for
a
proper
discussion
to
be
had.
D
I
think,
there's
really
a
low
awareness
of
the
tools
available
under
the
mental
capacity
act,
so
things
like
advanced
decisions
and
lasting
powers
of
attorney,
and
I
think
these
things
are
often
seen
as
kind
of
too
big
to
deal
with
people
say
things
like.
Oh,
I
just
don't
know
where
to
start,
but
we
know
that
when
they're
in
place
it
can
have
a
massively
positive
impact
on
the
quality
of
someone's
end
of
life
experience.
D
But
people
tell
us
time
and
time
again
that
they're
genuinely
baffled
by
terminology
and
that
they
research,
something
you
know
whether
that's
to
do
with
cpr
decision
making
or
other
end
of
life
decisions
only
to
find
out
when
they
go
to
their
gp,
that
actually,
what
they've
looked
up
isn't
in
use
in
that
in
their
area.
And
that
sounds
really
small.
But
actually
it's
not.
D
I
think
it's
barriers
like
that
that
stop
people
from
planning
ahead
when
they
want
to-
and
I
think
there
needs
to
be
a
clear
national
approach
to
end
of
life
record
keeping
and
information
sharing
as
well.
So
in
my
mind,
it's
just
totally
unacceptable
that
a
person
might
not
receive
the
treatment
or
care
that's
right
for
them,
because
their
wishes
can't
be
accessed
in
the
right
place.
At
the
right
time,
and
and
finally,
I
think
clinicians
have
to
feel
supported
to
raise
the
topic
of
end-of-life
planning.
So
yes,
definitely.
C
C
We
will
be
looking
forward
to
the
establishment
of
the
ministerial
oversight
group
to
make
sure
that
these
recommendations
are
followed
through
and
they
do
happen,
and
we
are
looking
forward
to
working
with
all
of
our
other
partners
across
the
health
and
care
system
and
the
voluntary
sector
and
all
a
variety
of
other
groups
to
make
sure
that
actually,
we
all
take
our
part
in
leading
these
improvements
and
driving
these
improvements.
We
will
continue
to
to
follow
things
up
very
carefully
at
the
cqc
and
as
the
independent
regulator.
C
B
B
And
we're
also
using
a
shared
hashtag
to
collectively
highlight
the
importance
of
advanced
care
planning
being
centered
on
the
needs
of
the
individual,
and
that
hashtag
is
talk,
end
of
life
care.
Please
do
share
it
talk
to
it
across
social
media
and
join
the
conversation.
So,
thanks
to
you
now
for
listening
and
taking
part
in
today's
podcast,
we've
lots
more
upcoming
podcasts
at
cqc,
so
join
us
next
time.
Thank
you.