The nation's health watchdog has told those running Queen Elizabeth Hospital in Woolwich to improve their 'do not resuscitate' orders after some confusion and inconsistency was found.

The Care Quality Commission (CQC) found that the orders, which were recently transferred from a paper-based system to online, contained inconsistency and problems with documentation.

A spokesperson for the trust confirmed that 'at no point has patient care been affected', adding that its electronic patient record system and DNACRP policy has since been updated.

This follows a recent unannounced, focused inspection of QEH in December 2020 after a inspectors received information from a CQC national review, triggering concerns about the safety and quality of DNACRP (do not attempt cardiopulmonary resuscitation) orders.

The orders mean that if a person has a cardiac arrest or dies suddenly, there will be guidance in place regarding whether or not to perform CPR on them.

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Decisions about DNACPR are based on a person’s individual clinical assessments and made following consultation with the patient where possible and may involve their family.

CQC’s Head of Hospital Inspection for London, Nicola Wise, said: “Queen Elizabeth Hospital had previously been using a paper-based system to record DNACPR orders and treatment escalation plans, but this has now been transferred to an electronic patient recording system.

"During our inspection, we found that there were some issues relating to the transfer of documentation to the electronic record software. This meant that there was some inconsistency in where information to support the DNACPR order was being recorded."

The watchdog has now ordered Lewisham and Greenwich NHS Trust to ensure its orders are support by treatment escalation plans (TEPs) which contain easily accessible and relevant information checked by senior staff.

It must also update the policy for TEPs to reflect changes made to the electronic patient recording system.

Ms Wise added: "However, we were pleased to see that the trust had identified the issues caused by the transfer of records and had put plans in place to ensure that these were addressed.

“The provider must now send a report to CQC outlining what action they will take in order to meet these requirements.”

The inspection team analysed 31 orders from four random words. and also conducted a number of staff interviews, policies, reports and papers.

The report said: "The patient treatment escalation plans (TEP) we reviewed did not always contain easily accessible and relevant information to the DNACPR order.

"We noted the completion of free text fields in the TEP were sometimes inconsistent and did not follow the trust’s TEP policy guidance."

It added: "However, all the orders we checked were authorised or endorsed by a senior clinician and were easily visible for healthcare professionals who may have needed to use them."

Inspectors were told that there were no cases where the issuing of a DNACPR order was done incorrectly.

A spokesperson for the Trust said: “The Trust has updated its electronic patient records system to improve alerts and enable clinicians to record discussions with loved ones in a place that’s easily accessible to other clinicians involved in the patient’s care. We have also updated our Treatment Escalation Policy (TEP) and DNACPR policy to reflect these changes.

“At no point has patient care been affected by the inconsistencies in the recording of family discussions, and there were no cases where the issuing of a DNACPR order was done incorrectly.”