Table.
Responses to questionnaire from 247 trusts on advance directives. Figures are numbers (percentages) of responses
| Trusts' replies | Trusts that have already developed a policy (n=37)* | Trusts intending to develop a policy (n=87)† | Trusts not intending to develop a policy (n=70)‡ | Other trusts (n=53)§ |
|---|---|---|---|---|
| Believe national guidance would be useful | 32 (86) | 83 (95) | 63 (90) | 9 (17) |
| Make provision for patients to indicate in advance their unwillingness to accept particular procedures or forms of treatment | 26 (70) | 2 (2) | 0 | 0 |
| When patients are admitted unconscious or otherwise unable to communicate, provide guidance for staff on approaching relatives or friends to ascertain whether advance directive already exists | 17 (46) | 1 (1) | 0 | 0 |
| If advance directive has not been drawn up, policies contain guidance for clinicians on need to approach relatives or friends, or both, to ascertain whether patient had expressed very definite views | 12 (32) | 1 (1) | 1 (1) | 0 |
| Steps are taken to ensure that all relevant clinicians are aware of the policy | 24 (65) | 1 (1) | 0 | 0 |
| Have developed guidance for staff who, for moral or ethical reasons, feel unable to comply with the policy | 11 (29) | 0 | 0 | 0 |
| Require that written information on making advance directives is freely available to relevant patients, relatives, and carers | 5 (13) | 1 (1) | 0 | 0 |
| Require that a member of staff on each ward should have specific responsibility for raising this issue with relevant patients | 2 (5) | 1 (1) | 1 (1) | 0 |
| Require that patients should be routinely advised on admission that advance directives may be discussed with ward staff | 0 | 0 | 0 | 0 |
| Provide information on how advance directives may be drawn up | 11 (29) | 1 (1) | 0 | 0 |
| Advise patients to notify staff of the existence of an advance directive | 8 (21) | 0 | 0 | 0 |
| Provide specific guidance on legal and clinical effects of advance directives on possible treatment under trust's care | 8 (21) | 11 (12) | 6 (8) | 0 |
| Requested illustrative copies of guidelines | 11 (29) | 59 (68) | 21 (30) | 38 (71) |
*
Acute 25, community 3, acute and community combined 9. †Acute 64, community 19, mental health 3, other 1. ‡Acute 43, community 20, children 1, mental health 2, other 4. §Acute 24, community 13, acute and community combined 8, children 2, mental health or learning difficulties 4, other 2.