Palliative Care / End of Life Care Guidelines

DNACPR – do not attempt cardiopulmonary resuscitation

In 2010 the South East Coast Strategic Health Authority (SEC SHA) set up a DNACPR working group as a sub-group of the End of Life Clinical Advisory Group. A set of principles were developed (DNACPR Principles) to be implemented across the SEC SHA area to bring consistency to DNACPR orders in all health care settings.

The principles provide for a single standard form to be used in all healthcare settings which should be recognised and followed by all organisations. The Resuscitation Council's model DNACPR order form was chosen and should be held by the patient when the patient is at home.

DNACPR order form

This (DNACPR order form) is a link to the form used in the locality covered by ; Western Sussex Hospitals Trust ; St Wilfrid's Hospice; and Sussex Community Trust. The form has two sections – a red bordered page which is the active form and normally held by the patient when in the community (or in the patient's file when an in-patient) and a grey bordered page which may be copied and sent to other providers such as the ambulance service. The form is available in carbonated pads.

Guidance notes for completing the DNACPR order

Guidance notes are available here (DNACPR form Guidance). The guidance notes are also included in the carbonated pads

Location of completed DNACPR orders for patients at home – Message In A Bottle containers

To allow emergency ambulance crews to locate a completed DNACPR in a patient's home the SHA principles suggest the use of the Message In A Bottle system. Information and how to access supplies of the containers are available here (MIAB Containers).

The following links provide further useful information

Decisions related to cardiopulmonary resuscitation: a joint statement from the British Medical Association; Resuscitation Council and the Royal College of Nursing 2007

Resuscitation Council guidelines


CWS CCG Clinician?  Click here for news, clinical discussion, prescribing information and other palliative care guidelines

Message In A Bottle (MIAB)

Where to obtain supplies of Message In A Bottle containers?

The South East Coast SHA DNACPR principles indicate that; for a patient at home; a DNACPR order should be stored in a location which is easy to identity for an ambulance crew in an emergency.

One such method in the Message In A Bottle (MIAB) system sponsored by LIONS Clubs. The DNACPR order is placed in the patient’s fridge and an identifying sticker is placed on the back of the front door – ambulance crews know to look for the sticker.

MIAB bottles are supplied by Lions Clubs

Find your Local club from one of the 15 Lions Clubs covering the Coastal West Sussex area 

Alternatively the following people are local leads for supplying MIAB:

  • Chichester Lions 0845 833 9605

  • Worthing Lions 01903 535784

  • Midhurst Lions 01730 813606

  • Bognor Lions 0845 833 7495

  • Littlehampton Lions 0845 833 2748

If these people are not able to provide MIAB containers they will know who you should contact