Contents
1 Scope
The recommended summary of emergency care and treatment (ReSPECT) plan is a record of key information to use in future emergency care and treatment, at a time when an individual may not be able to communicate what matters to them. South Yorkshire Integrated Care Board (ICB) have developed a regional wide policy for recommended summary of emergency care and treatment.
The trust also has services that are in North Lincolnshire. Whilst North Lincolnshire region may have a policy that covers the recommended summary of emergency care and treatment, this standard operating procedure outlines the expectations for all trust colleagues regarding the recommended summary of emergency care and treatment process under the regional policy, including documentation, training and audit.
Target audience is all clinician colleagues across the trust.
2 Procedure
The regional policy sits within the trust resuscitation manual and meets the expected requirements for all trust care groups. It clearly defines expectations such as who should have such conversations, which clinicians can complete the document, how to complete the document, how to cancel the document, training and audit processes. This procedure covers specific expectations for all trust care groups in addition to the regional policy.
2.1 Expectations for clinicians
All clinical colleagues should have an awareness of what a recommended summary of emergency care and treatment plan is. This is to provide the wider knowledge if a patient has an emergency plan of care in the clinical setting and colleagues know how to escalate appropriately.
Recommended summary of emergency care and treatment (ReSPECT) conversations and completion of the form should only be completed by professionals who have completed the appropriate training and who are competent and autonomous in the decision making for the level of medical escalation that is appropriate for the individual in their particular situation, for example:
- doctors
- nurse consultants
- advance clinical practitioners
- clinical nurse specialists in specialist palliative care
- heart failure and respiratory
All clinicians who are completing the forms must have completed a level of training as suggested in the overarching policy. For nurse specialists within the trust there is an expectation to have a discussion with the recommended summary of emergency care and treatment lead regarding training for ongoing oversight of the recommended summary of emergency care and treatment process.
2.2 Documentation in the electronic patient record (EPR)
When completing a recommended summary of emergency care and treatment (ReSPECT) plan with a patient, it important to keep a record in the patient’s electronic record.
If completing a paper version, this must be scanned into the patient’s record with the title “ReSPECT” into communications and letters. If in the community, take a picture on your work mobile phone and send it via secure email to the clinician’s services administration assistant who can upload this to the record.
If completing the digital version, this can be found in templates (F12), or via the “RDaSH DNACPR/ReSPECT” tab in the left-hand tree. If completing the digital version, a copy must be printed and given to the patient. The printed version may be black and white. The signature will be typed (see main policy).
In addition to the recommended summary of emergency care and treatment plan being completed: for all versions, the clinician must complete the “RDaSH DNACPR/ReSPECT” template in the patient’s record. This is a template that captures the discussion and provides read code for audit.
Completing the Rotherham, Doncaster and South Humber NHS Foundation Trust do not attempt cardiopulmonary resuscitation (DNACPR) and recommended summary of emergency care and treatment (ReSPECT) template:
- Press F12 and type in ReSPECT in the search, “RDaSH DNACPR/ReSPECT” will be available, or click the link in the left-hand tree.
- A green information page will give instructions for the clinician, click the grey Respect tab at the top on the page:
- complete the boxes in the template that are applicable, it is important to select a resuscitation decision, for example, not for attempted cardiopulmonary resuscitation (CPR) and capture the discussion
- if a patient has been admitted to the ward with a recommended summary of emergency care and treatment plan, or the plan is being reviewed in the community, the template should be completed to record that “section 9” of the plan has been completed, and the recommended summary of emergency care and treatment plan remains appropriate
- this review should only be completed by colleagues that can amend the plan, however all colleagues should have an awareness of a poorly completed plan and escalate this to a colleague for amendment, for example, staff nurse on a nurse-led unit escalating to an advance clinical practitioner, or staff nurse escalating to a nurse consultant
2.3 Audit
The recommended summary of emergency care and treatment audit is on the digital incident system and is due in March and September every year.
When the audit is due it will appear on the ward or clinical area audit list.
The audit must be completed no later than the last day of the month.
All inpatient wards in Rotherham, Doncaster and South Humber NHS Foundation Trust must complete the audit.
For colleagues who work in the community, for example, advance clinical practitioners in virtual ward, specialist palliative care and cardiac services, who have recommended summary of emergency care and treatment conversations and complete the recommended summary of emergency care and treatment plans, it is important to keep a record of the plans completed for a random selection to be audited by the audit lead, as per the audit calendar.
The audit has 2 parts:
2.3.1 Recommended summary of emergency care and treatment pre–audit
All wards need to complete this. The aim is to identify how many ward areas have patients with a recommended summary of emergency care and treatment plan (this pre-audit takes less than 30 seconds to complete).
If the ward area does not have any recommended summary of emergency care and treatment plans, the audit is finished, and no further action is required.
2.3.2 If the ward area does have patients with recommended summary of emergency care and treatment plans
Recommended summary of emergency care and treatment audit will appear in the audit list within 60 minutes of completing the pre-audit. This audit reviews the quality of the forms that have been completed. Complete all the questions. This audit will be assigned to one named person, that person can reallocate it to someone else.
2.4 Training
The trust’s expectation is:
- tier 1: all clinical colleagues who do not complete the recommended summary of emergency care and treatment plans (6-minute video)
- tier 2: all clinical colleagues who regularly care for patients who may have a recommended summary of emergency care and treatment plan
- tier 3: all clinicians who have recommended summary of emergency care and treatment conversations and complete the forms
When completing the form ensure:
- that the information is helpful to the clinician who is needing to use it, for example, Yorkshire Ambulance Service
- not to use language such as ward level care, level 2 care as this does not have meaning to the wider community
Refer to section 5.2 of the regional policy for what each tier requires.
3 Any related documents
The overarching policy for this standard operating procedure is the South Yorkshire Integrated Care Board recommended summary of emergency care and treatment (ReSPECT) policy located in the resuscitation manual.
Document control
- Version: 1.
- Unique reference number: 1115.
- Approved by: Clinical Effectiveness Group.
- Date approved: 7 January 2026.
- Name of originator or author: nurse consultant in specialist palliative care.
- Name of responsible individual: chief nursing officer.
- Date issued: 24 February 2026.
- Review date: 27 February 2029.
Page last reviewed: February 24, 2026
Next review due: February 24, 2027
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