The ReSPECT Process


The Recommended Summary Plan for Emergency Care and Treatment (ReSPECT)  is a nationally recognised and endorsed form for Do Not Attempt Cardiopulmonary Resuscitation (DNACPR). This process has been trialled in three sites across the UK and an evaluation is currently underway and awaited. 

The process is now being rolled out nationally in trusts and localities. The Network (YHCPCN) endorses and supports the use of the ReSPECT process across the region. It is hoped that all services supporting children and families with LLC or LTC will sign up to the ReSPECT process. This will ensure consistency for children and their families as well as for professionals. 

The ReSPECT process will replace the Limitation of Treatment Agreement        (LOTA) form which is currently in use for children with life limiting and life threatening conditions across our region. It is acknowledged that there will be a period where both the ReSPECT and LOTA will be in circulation and this is unavoidable. It is a phased implementation across the region and cannot be unified due to the number of trusts and organisations that are needed to sign up to the process and put this through their internal governance structures.

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What is the ReSPECT process?

It is a process which creates personalised recommendations regarding clinical care in a possible emergency situation where the person may be unable to make choices / decisions. These are recommendations only. It gives professionals a summary of those recommendations and helps make immediate decisions in an emergency situation. 

When can the ReSPECT Process be used locally?

The ReSPECT process can only be used locally when it has been established and embedded in your locality and has been through governance procedures. In order to establish ReSPECT locally your organisation needs to sign up to the implementation Network via 

It is hoped that the process will be established across the whole region to ensure recognition and consistency for children and families. 

The process must be ratified and embedded into local governance procedures and MUST be formally adopted locally across both primary and secondary provider services.

The ReSPECT terms of use MUST be signed up to prior to local roll out. 

The process is currently going through governance with Hull Children and Adult services, Leeds Children and Adult Services and Sheffield children's hospital trust. It is hoped that others will come on board in a phased approach to roll out across the Region. 

What if my organisation is NOT signing up to use the ReSPECT process?

All organisations and professionals should be clear that there is a period of overlap and that both forms will be in use and should be recognised and acted upon. If your organisation is NOT signing up to use the ReSPECT process it is important to have a discussion about how the organisation will manage cases where children and young people are coming in with the ReSPECT forms (other areas may be using them). This should be an agreed protocol to ensure all are clear on how to manage this situation. There are local examples where this has been written into guidance and procedures. 

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