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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.

Midazolam by Buccal Administration for Children (UTC)

PGD Midazolam by Buccal Administration for Children (UTC)

APPENDIX 5 HRP23 Formal Notification of Return Date from Adoption Leave .docx

DCHS Policy Update_October 2024.docx

A7 - Patient Enquiries to Respiratory Administration (S88).docx

Disclosure Ref 2025171 - Referral for MRI scan.pdf

Freedom of Information disclosure reference 2025/171 relating to A&E guideline procedures for referring patients to MRI scans

Intergrated Performance Report - November 2025

Intergrated Performance Report - November 2025

Escalation Report Template - July 2022.docx

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Dressing Formulary and Wound Care Guidelines (G68)

The Derbyshire Wound Care and dressing formulary has been revised in collaboration with the East Midlands Wound Care Formulary Group. Work has been undertaken to provide a clinically effective, appropriate and cost effective choices of products to manage the vast majority of wounds. The formulary is available for all practitioners working for Derbyshire Community Health Services and Primary Care Services. It is expected that prescribers will preferentially use the products listed in the guide for routine use and be able to provide robust rationale where they have prescribed outside the formulary.

Medicine Code (S2)

This Code defines the roles and responsibilities of all health care professionals and ancillary staff involved in the ordering, storage, distribution, prescribing, dispensing and administration of medicines within DCHS. This Medicines Code extends the previous Medicines Codes and reviews them in light of current legislation and guidelines.