GPs reminded of importance of notifying hospitals of advance decisions by patients

GPs are being reminded about the importance of notifying hospital colleagues of an advance decision by a patient, if they become aware that a patient has been admitted for treatment.

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

The warning follows a recent legal case in which a patient who was 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.

The judge in the case acknowledged when advance decisions have been drawn up and placed with GP records, there is an 'onerous burden' on GPs to ensure that wherever possible they are made available to clinicians in hospital.

Dr Kathryn Leask, MDU medico-legal adviser, 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.'

The MDU has issued advice about the implications of the recent judgment to members.

This guidance was correct at publication 03/05/2019. It is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.

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