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ReSPECT Level 1: Awareness

ReSPECT Level 1: Awareness
Training to teach staff how to recognise the form, and what it stands for.

  • What is ReSPECT and how is it different to what we have already?
  • Who is ReSPECT for?
  • What does the form look like?

Training resources have been developed based on resources produced by the Resuscitation Council and early implementers. We are very grateful to colleagues in Sussex, NHS Forth Valley, Lincolnshire and Worcestershire who have shared their learning and resources with us.

Contact us for access to our implementation workspace which includes:

  • Master training slides for all levels of training (PPT)
  • Trainers’ handbook with reference information (PDF)
  • Guidance for clinical staff editable versions for local adaptation (PPT)
  • Training needs analysis (Word)
  • Printable blank ReSPECT forms and editable PDF forms

What is ReSPECT and how is it different to what we have already?

ReSPECT (Recommended Summary Plan for Emergency Care and Treatment) is a process to plan a person’s clinical care in the event of a future emergency when they might be unable to make or express choices.

Across the West of England, there are many different Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) and treatment escalation plans (TEPs). Adopting ReSPECT creates a common language which is nationally recognised that supports shared decision making between a person and their healthcare professionals.

The process is that competent staff guide selected patients through an extended conversation, often taking place over several contacts to allow families and carers to be involved.

The process results in a completed ReSPECT form which includes a person’s personal priorities for care and agreed clinical recommendations about care and treatment that could help to achieve the outcome that they would want, that would not help, or that they would not want.

The ReSPECT form will record a Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) recommendation if one has been made. However, ReSPECT is about much wider care preferences and is equally applicable to patients for whom an attempt at resuscitation is appropriate.

ReSPECT is a process of conversations, communication, and taking action on those conversations. The ReSPECT process is about the conversation and the form is there to support it.

Within acute hospitals in the West of England, Trusts have agreed that they will use the ReSPECT form as a summary to complement inpatient TEPs which may be more detailed to reflect an individual’s clinical circumstances.

The ReSPECT form applies across all settings. Once the recommendations are recorded they travel with the person, and can be updated when necessary.

Who is ReSPECT for?

ReSPECT can be for anyone who wants to record their care and treatment preferences, but particularly those who have complex health needs, are likely to be nearing the end of life, or at risk of sudden deterioration or cardiac arrest.

Too few of our most frail and complex patients have advance care plans that describe what should happen in an emergency. This means that clinicians and carers have to make decisions about a person’s best interests and preferences and some very frail patients are resuscitated when they would not wish to be.

Many people are also taken to hospital in an emergency when they would have preferred to stay at home. They often recover much more slowly in hospital than they would have in more familiar surroundings.

The ReSPECT process is best started and the form completed when a person is relatively well.

What does the form look like?

The ReSPECT form is a two-sided lilac coloured A4 form.

Image of a ReSPECT form

  • Download a specimen ReSPECT form. Print ready and editable PDF versions are available on our implementation workspace.

There are nine sections to the form.

  1. Personal details
  2. Summary of relevant information for this plan
  3. Personal preferences to guide this plan (when the person has capacity)
  4. Clinical recommendations for emergency care and treatment
  5. Capacity and representation at time of completion
  6. Involvement in making this plan
  7. Clinician’s signatures
  8. Emergency contacts
  9. Confirmation of validity (used when the form is reviewed)

The ReSPECT form should be used in colour wherever possible. Where a form is printed in black and white we recommend that it is printed on lilac coloured paper if possible.

However, the colour of the form does not invalidate a properly followed ReSPECT process, or the preferences and clinical recommendations recorded on a form that has not been printed in the recommended colour format. 

Avoid copying ReSPECT forms wherever possible. When copies are required for local process they need to be clearly marked “COPY”.

Please note the ReSPECT form itself should not be altered or added to in any way.

Once you have completed Level 1 Awareness carry on to Level 2 : Action