36 Evaluating the quality of ReSPECT plus shared care plans across community services in Bristol, North Somerset and South Gloucestershire Integrated Care Board

Background The 'Recommended Summary Plan for Emergency Care and Treatment' (ReSPECT) process has been implemented nationwide, which records patient priorities and clinical recommendations (including resuscitation decisions). 'ReSPECT Plus' is an electronic shared care plan, developed and introduced across Bristol, North Somerset and South Gloucestershire; this allows the creation and access to shared care plans by healthcare providers in real time. Our aim was to evaluate quality of completion of these shared care plans. Methods There are no pre-existing standards for completion of ReSPECT Plus. A working group from primary, community and hospice settings reviewed the plans, with consensus option reached on areas of completion thought to indicate minimum and high-quality completion. 109 plans of patients who had died in 2023 and were known to primary care teams, community care teams or the local hospice team were accessed and evaluated. Results were anonymised. Results Seven items were determined to indicate the 'minimum quality' of a well-completed form. 72% of the completed forms had five or more items completed. 25% documented all seven items. More than 90% of forms recorded primary diagnosis and CPR decision. Patient priorities, values and preferred place of death were less likely to be recorded. There was more variability of areas considered to indicate 'high-quality' of completion, such as whether prognosis or emergency contacts were documented. 98% of forms documented patient understanding. Conclusion The following minimum standard items had been completed in over 80% of patients: diagnosis, resuscitation status, emergency care and treatment plan. The following high-quality items had been completed in >90% of patients: clinical summary and awareness of diagnosis. These figures show that the vast majority of plans will provide easily accessible guidance on appropriate treatment decisions. The personalised nature of each plan is likely reflected in the variability of areas the plans that are completed.