We are pleased to be able to present Devon’s first End of Life Strategy, which we see as a comprehensive programme to transform the care given to people approaching the end of life, their families and carers over the next few years.

Please click the link below to view or download the strategy document:

• Dying Matters in Devon - Strategy for Living Well Until the End of Life 2010 - 2015

Introduction of the Treatment Escalation Plan (TEP) and Resuscitation Decision Record

Click the link for the Treatment Escalation Plan website.

Devon LMC has been involved in discussions regarding the use of a county wide unified Do Not Resuscitate (DNAR) and Treatment Escalation Plan (TEP) form. These forms are designed for use in people who have illnesses that may shorten or limit their life. It allows them to express some choices around treatment decisions towards the end of life.

It has been agreed to release these forms for use from 5th March. A number of areas within the county already use earlier versions of the forms and some areas have been involved in pilots. The newly agreed form has been released earlier than planned in some areas without a detailed narrative around their use.

The key messages that accompany the form are:

1. The Treatment Escalation Plan (TEP) and Resuscitation Decision Record is a clinical decision making tool and common sense should be applied to who should have one.
2. Only complete appropriate boxes.
3. The Treatment Escalation Plan (TEP) and Resuscitation Decision Record form should be completed in collaboration with the patient and family where possible and should be reviewed over time.
4. The Treatment Escalation Plan (TEP) and Resuscitation Decision Record is only good if everyone knows it exists – update the Electronic End of Life Register (Adastra).
5. The Treatment Escalation Plan (TEP) and Resuscitation Decision Record travels with the patient wherever they go.

The LMC supports the use of the form. GPs may be asked to complete them on patients with malignant and degenerative life limiting illnesses. Please complete only the boxes that you feel competent to complete and have counselled the patient about. If you chose to complete a form please add the patient to the Adastra end of life register.

It should be acknowledged that the forms take time to complete and only should be completed if both patient and clinician are in complete agreement that it is appropriate. The LMC would support clinicians in resisting the completion of the forms when it is not in the best interest of the patient to do so.