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Advance Directive - Living Wills


Advance Directive - Living Wills

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									            The Royal Bournemouth & Christchurch Hospitals NHS Trust



An Advance Directive is a formal written document, which tells the doctor what
kind of care a patient would like to have if they become unable to make

Advance Directives can take many forms. A good one describes the sort of
treatment a patient would want for different levels of illness, such as if they
have a critical illness, a terminal illness, permanent unconsciousness or

An Advance Directive usually tells the doctor what certain types of treatment if
a patient is ill (such as to be put on a Ventilator if you are in a coma) but they
can also say that you would like a certain treatment no matter how ill you are
(this might include basic therapies but in the UK at least doctors are not
obliged to give you every possible treatment.

Purpose of guidance:

All patients have the right to influence the clinical treatment advised by the
health professionals. They also have the right to have a note made on their
health record of their personal wishes regarding future treatment.

The patient may communicate their wishes to us in the form of an obvious
legal document or a personal letter.

It is also possible for the patient to give a verbal directive. This should always
be entered in the patients health record.

Relevant to:

All staff who come into contact with patients.

National Definitions:

Advance statements about medical treatments (1995) – BMA IBSN 0727909142

Reference Material:

Trust Policy Advance Directive (Living Willis) Information Governance Folder
Case note Folder
Computer System.

AG/TAT/Advance Directive – Living Wills/Oct2000/RevOct02/Rev/July03
Implications of not following the process:

It is against the law to ignore a Living Will or Advance Directive. It is vital that the
patient’s wishes are taken into consideration, especially if they are not able to
communicate on the day of admission or attendance.

Useful contacts:

Ann Gale Caldicott/Data Protection Officer ex 4461

PROCEDURE On receipt of the Living Will or Advance Directive:

1        Advanced Directives / Living Wills should always be put in writing. If
         verbal this should be identified in the patients medical records.

2        Send the letter and notes (if you have them in your possession) to Ann
         Gale, Caldicott/Data Protection Officer, Admin Floor, Royal
         Bournemouth Hospital).

3        If a letter is received without notes, request the notes using CRT.

4        Ann Gale will register the letter and complete the Advance Directive /
         Living Wills form.

5        Register on the Camis System, instructions in folder.

6        A copy of the patient’s letter will be placed in the patients’ notes under
         the identification sheet.

7        An acknowledgement letter will be sent to the patient advising them
         that the Trust will follow their instructions from the acceptance date.

8        The patient will be advised that the information and date will not be
         erased from the computer or medical notes unless we are instructed by

9        The patient is advised to carry these instructions in the event of being
         admitted to any other hospital in the country as an emergency.

10       To maintain strict adherence to the patient’s wishes this procedure for
         putting this information on the PMS system is only carried out by Ann
         Gale, Caldicott/Data protection Officer. In her absence, Sarah Hill,
         Head of IT will be able to deal with this request.


AG/TAT/Advance Directive – Living Wills/Oct2000/RevOct02/Rev/July03
AG/TAT/Advance Directive – Living Wills/Oct2000/RevOct02/Rev/July03

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