Do not resuscitate orders imposed on thousands of patients without families' consent

An audit found one in five families were not informed of the plans

The college estimated 200,000 patients each year are issued with the order for health workers not to attempt cardiopulmonary resuscitation (Justin Sullivan/Getty Images)

Up to 40,000 patients a year are having do not resuscitate orders imposed without their families' consent, an audit has found.

Hospitals are failing to tell relations they do not intend to attempt potentially lifesaving techniques to save their loved ones, according to the Royal College of Physicians.

Its audit of 9,000 dying patients found one in five families were not informed of the plans - the equivalent of 40,000 patients a year, the Daily Telegraph reported.

The college estimated 200,000 patients each year are issued with the order for health workers not to attempt cardiopulmonary resuscitation (CPR).

In 16 per cent of cases, the study found there was no record of a conversation with the patient about the order.

The audit's chairman, Professor Sam Ahmedzai, told the Telegraph: "When a decision has been taken, it is unforgivable not to have a conversation with the patient - if they are conscious and able - or with the family."

He also said doctors needed to be more open with dying patients, as half of patients identified as likely to be dying were dead within a day.

"This is being done very late in the day - as doctors we just don't like to face up to it," Prof Ahmedzai added.

An NHS England spokeswoman said: "We welcome the results of this audit, which we commissioned, and which shows there has been some improvement in the care provided.

"But there is clearly more that can be done.

"Although this audit presents a snapshot of end-of-life care within NHS hospitals, there are clear variations in the support and services received across hospitals and areas where improvements must continue to be made."

Prof Ahmedzai said the medical profession needed to do better but in many cases resuscitation would be inappropriate.

"The majority of people who are dying in hospital are not dying of sudden heart attacks or blood clots, they are dying with cancer, with dementia, with other chronic conditions and that is meant to be a peaceful passing away," he said.

"It would be quite inappropriate for a doctor, a crash team, to come along and start pounding on the chest, putting tubes in when actually the person is reaching the end of their life and no amount of resuscitation is going to help."

But he told BBC Radio 4's Today programme that more needed to be done to inform patients' families about the decision: "We have to confess that actually we are not as good at this as we should be."

Explaining some of the 20 per cent of cases where no-one was informed, he said: "Often it's because there was no family member - a person living alone or from a care home - or because we tried to contact the person but were unable to do so in time".

Additional reporting by Press Association