There’s a scheme in operation in the South-West,
a form, filled in for you, they deem to call
‘ReSPECT’; restricting options you might think best –
which, to my mind, affords no respect at all

Abbreviations? No, I’m not their greatest fan,
and many medical ones, we know, don’t fit the bill;
this one means your ‘Recommended Summary Plan
for Emergency Care and Treatment’, when you’re ill

It was brought in, 2019, designated
as assisting patients’ wishes, so they said,
not to have resuscitation, but was soon appropriated
by our hospitals, to withhold it, instead

No voluntary input through your GP
as promised; soon as you hit A & E
they’ll pounce on you, if you’ve lost your capacity,
wait until your carer’s absent, if need be

And enforce utilisation of this damn form
(A measure to be rolled out nationally?);
even worse, once you’ve returned home, what d’you think’ll be the norm?
Why, it’ll be shared with others, electronically

There’s simply no escaping from these predatory lurkers.
The consequence? You’ll henceforth be denied
CPR by ambulances, and all other health care workers –
however much loved ones thought it applied

And they’ll write what the hell they choose as an extension –
that you’re dying, or have months to live at most;
and this they’ll do without forewarning, never mention,
then send it out, and through your front door, via the post

Like an unwanted souvenir of your admission,
to read for the first time, when you’re alone,
and frighten the wits out of you, as, listen,
there’s no medic ‘to explain’ now you’re at home

Apologies? Forget it! It’s a ‘job done’;
one more lined up to get rid of, soon as poss;
one less nuisance of a patient for attention ,
taking up their beds – but it’s our, and not their, loss…

I believe usage of this form can cause significant unintended harm. As I believe it did my own mother.

It is not the right place for elliptical promulgation of bald, one line, overarching medical assessments. Which, in different settings, may be prejudicial to determination of treatments appropriate, not disproportionate, to the narrower time frame. And therefore – in terms of outcomes – positively dangerous.

According to NHS discussion on line, the avowed intention in introducing this form was to assist advance care planning – via community settings, such as your GP practice – on the elective part of a patient In short order after its trialling, it appears to have been proactively applied, instead – to those (even intermittently) without full mental capacity.

These NHS tentacles are being stretched, ever more resolutely, out. Not now just from admission to hospital, but mere attendance at A & E. And the treatment restrictions enforced soon intended to be imposed all the more inescapably – no longer by form, but electronically. Top down, across all NHS services (though predominantly, of course, ambulances). 

Would that the will to join up care in the community, via different, and supposedly integrating, NHS services, were always so markedly to the fore.

When, entirely independently of each other (for the paramedic had suppressed the GP’s request he was asked to put to me, as an option – something on which
South-Western Ambulance Service Trust says it cannot comment), both I, and the GP, asked a crew to stay with my mother, on the night of her death, until the GP’s  arrival, within the hour – in order that, with an A & E ambulance stack even then, as the paramedic himself had made mention, of four hours, an even longer wait for transportation to hospital should not accrue, if attendance were indeed deemed necessary when the GP came – this was refused as an option.

Why? Because…the crew were due off shift. They left at 02:08, the GP arrived at 02:28. Queues (even to queue!) to get a 999 pick up all evening previously…and still.

Never heard of shift relief, SWAST? It happens all the time. This ambulance (at Category 2) had already taken 3 hours 10 minutes to arrive (instead of 18 minutes or less).

What a brass neck…