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GPs urged to inform hospital staff of patient advance decisions

GPs have been urged to inform hospitals of advance decisions by patients, following a recent legal case. 

Medical defence body MDU has said this communication ‘shouldn’t be on the phone alone’ to avoid misunderstandings. 

This comes after a legal case in December, whereby a patient in a persistent vegetative state was kept alive for almost three years, despite having a valid advance decision in her GP record refusing all treatment.

In this case, the judge acknowledged that when advance decisions have been drawn up and placed in GP records, there is an ‘onerous burden’ on GPs to ensure that, wherever possible, they are made available to clinicians in hospitals.

Advance decisions enable an adult with capacity to refuse specific medical treatment for a time in the future when they lack capacity.

MDU has reminded GPs of the importance of informing hospitals about advance decisions if they are aware a patient has been admitted for treatment. 

Medicolegal adviser at MDU Dr Kathryn Leask said: ‘The judgment has made it clear that GPs who are aware a patient with an advance decision has been admitted to hospital, have a responsibility to ensure the treating clinicians are informed of this. GPs should provide a written copy to avoid any misunderstandings.

‘If GPs are aware that a patient has made an advance decision, it’s important to record this in the patient’s notes. GP records could be flagged so that the existence of an advance decision will be obvious when the notes are accessed. Doctors should also encourage the patient to tell family members or close friends so they can inform healthcare professionals, for example, if the patient is admitted to hospital as an emergency and lacks capacity.’

An MDU spokesperson added: ‘While the judgement doesn’t change the law, it has underlined GPs’ professional responsibility to make sure information is passed on to hospital colleagues in the circumstances outlined.

‘As a result of the judgement, GPs are advised that a copy of the decision itself should be made available to colleagues, which inevitably means some written communication. This doesn’t mean GPs can’t back this up with a phone conversation however, but the communication shouldn’t be on the phone alone.’