Download Collaboration for Leadership in Applied Health Research and Care

Treatment Escalation Plans (TEPs):
Recording Decision-making for an
emergency
Prof Alison Richardson: Clinical Professor of
Cancer Nursing and End of Life Cafe
Sarah Bogle: TEPs Project Manager
Collaboration for Leadership in Applied
Health Research and Care (Wessex)
Why is TEP needed?
• DNACPR process has its limitations: a negative withholding of
treatment not an overall plan for treatment
• Decisions and plans made too late in the day for many
• Encourage and trigger an important conversation earlier
• Only 4% have treatment plans when they die currently
• Importance of shared decision-making between patient (and next of
kin) and the clinician
• Local TEPs have been generated, e.g. Devon TEP since 2006,
Cambridge UFTO
• Many national reports and committees recommending action
• Court judgments, e.g. Tracey, Winspear
Collaboration for Leadership in Applied Health Research and Care (Wessex)
What is TEP?
My wishes are
respected if I
my health
deteriorates
Treatment
plan in an
emergency
Capture
priorities and
goals of care
Shared
decisionmaking
A summary
record for all
care settings
Ceilings of
treatment at
end of life
Avoid
confusion and
distress in
emergency
situations
A difficult but
important
conversation
between patient
and clinician
Collaboration for Leadership in Applied Health Research and Care (Wessex)
National Working Group
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Emergency Care and Treatment Plan (ECTP) – the title may change
National form and process for all of UK and all age groups
Treatment options that include decision on CPR
Co-chaired by Resuscitation Council (UK) and Royal College of
Nursing
Formed in February 2015
Consultation January-February 2016
Current activities: review of consultation feedback, communications
planning, further engagement, pilots in different settings
Plan to launch by November 2016
Implementation approach most likely to be ‘over to you’ to lead
locally
Collaboration for Leadership in Applied Health Research and Care (Wessex)
Questions for you
• Who might need one?
• Who might start the conversation?
• What should happen when it is
completed?
Collaboration for Leadership in Applied Health Research and Care (Wessex)