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New guidance for discussing decision making on levels of care

The RCP has published a framework to support staff in discussing and documenting decision making on levels of care in clinical practice.

This new guidance has been designed to provide a clear framework for ethical discussions to support decision making and documentation in clinical practice. It outlines a structured, patient-focused approach suitable for use by all professional groups, specialties and in all care settings and can be used in relation to any disease or diagnosis to ensure fair and equitable care for all.

Discussing available options for treatment and care with patients is part of everyday clinical practice and often straightforward, where the options are evidence-based, available within the particular healthcare setting and patients are clear about their wishes.

However, decisions regarding escalation, de-escalation or a change in the level of care can be much more complex and challenging.

An accompanying Ethical Care Decision-Making Record (ECDMR) has been designed for use in more complex situations, to facilitate a discussion about care and assist with recording information, discussions and decisions.

The RCP is inviting feedback so that the guidance and ECDMR can be continuously improved.