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Advance Decisions Policy

It is a general principle of law and medical practice that adults have a right to consent to or refuse treatment. The courts have recognised that adults have the right to say in advance that they want to refuse treatment if they lose capacity in the future, even if this results in their death. A valid and applicable advance decision to refuse treatment has the same force as a contemporaneous decision. This has been a fundamental principle of the common law for many years and is now set out in the Mental Capacity Act 2005, which came into force in 2007 supported by the Code of Practice to the Act. Derbyshire Community Health Services NHS Foundation Trust aims to achieve a more balanced partnership between patients and healthcare professionals and acknowledges that it is the right of every adult patient with capacity to determine whether or not to accept medical treatment. In addition, it is the right of every adult patient to express views about their future care and treatment. The primary responsibility lies with the patient (the maker) to write an Advance Decision to Refuse Treatment (ADRT). The Trust endorses the good practice of staff, set out in national guidance and professional standards to provide information to and general support for patients who wish to write an ADRT. The Trust always encourages patients who wish to discuss their plans for future care and will provide advice to patients and support to advance care planning by helping to coordinate care and communicate plans. In addition, it is supportive of those patients who present with an advance decision and where this is valid and applicable, comply with that specific decision. This policy should be read in conjunction with the Trust’s Consent Policy and aims to raise awareness and give guidance to staff about advance decisions.

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Homely Remedies SOP (S16)

Under normal circumstances, medicines should be administered either on the written prescription of an authorised prescriber, in accordance with the Medicines Code or under the authority of a Patient Group Direction. The Medication Optimisation Safety Team (MOST) has approved a list of non-prescription medicines or “homely remedies” that registered nurses and registered practitioners are authorised to administer at their own discretion, in accordance with the attached standard operating procedure, for a maximum of 48 hours (extended to 72 hours over a bank holiday weekend). The homely remedies approved are treatments commonly available over the counter for minor, short-term conditions without the need for a prescription or Patient Group Direction.