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Dear David

I welcome Professor Crome's response to the draft CPR Statement www.bgsnet.org.uk/Oct07/12_cardio-resus.htm, however, the sentence " . . . . this advice led many hospitals to believe firstly that the issue of CPR should be raised routinely with all admissions, and that secondly a DNAR decision by the medical team must be discussed with the patient if possible, regardless of the context." should also have referred to HSC 2000/028.

The circular required Trust chief executives to ensure staff placed patients' rights at the centre of decision-making and to identify a non-executive director to oversee implementation on behalf of the Trust Board. And finally, to emphasise the importance attached by Department of Health the (then) Commission for Health Improvement was asked by the Secretary of State to pay particular attention to resuscitation decision-making processes as part of its rolling programme of clinical governance reviews.

Little wonder that staff felt compelled, often against their professional instincts, to routinely discuss cardio-pulmonary resuscitation. We should acknowledge that powerful forces were in play at the time resulting in the problems addressed in the draft guielines.

Yours sincerely,

Tony Luxton
Consultant Community Geriatrician

BGS Newsletter, December 2007
Issue 14 ISSN 1748-6343 14