DNACPR Wales — How Do Not Resuscitate Forms Work and Who Decides
DNACPR Is a Clinical Decision, Not a Patient Document
A Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) form in Wales is completed by a doctor, nurse consultant, or certified Advanced Paramedic Practitioner — not by the patient. This is one of the most widely misunderstood aspects of end-of-life planning. You cannot download a DNACPR form and fill it out yourself.
The All Wales DNACPR form records a clinical judgment that CPR would be medically futile or not in the patient's best interests given their current health. The clinician makes this assessment based on the patient's condition, prognosis, and — critically — their previously stated wishes, including any valid ADRT.
The form is completed during a consultation, and NHS Wales policy requires that the discussion involves the patient (if they have capacity) or their family and any Health and Welfare LPA attorney. The completed form stays in the patient's medical notes, and a copy should be scanned to the Welsh Care Records Service for visibility on the Welsh Clinical Portal.
How DNACPR Differs From an ADRT
The distinction matters because confusing the two can leave dangerous gaps in your planning:
| Feature | DNACPR | ADRT |
|---|---|---|
| Who creates it | A clinician | You (the patient) |
| Legal status | A clinical communication tool | Legally binding under the Mental Capacity Act 2005 |
| What it covers | CPR only | Any treatment you choose to refuse |
| When it applies | Based on current clinical circumstances | When you lose capacity in the future |
| Can you request it | Yes, but the doctor decides | You decide — the doctor must follow it |
A DNACPR form tells the resuscitation team not to attempt CPR. It says nothing about ventilation, artificial feeding, antibiotics, dialysis, or any other treatment. An ADRT, by contrast, can refuse any or all of those treatments — including CPR.
If you have a valid ADRT that refuses CPR under certain circumstances, and those circumstances arise, the clinical team should complete a DNACPR form to operationalise your ADRT. The ADRT is the legal authority; the DNACPR form is the clinical instruction that translates that authority into a format paramedics and ward nurses recognise instantly.
What About ReSPECT Forms?
The Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) is used in some parts of the UK as a broader emergency care plan. It covers more than just CPR — it can include preferences around hospitalisation, escalation of treatment, and comfort-focused care.
In Wales, the All Wales DNACPR form is the standard clinical document. Some Welsh health boards use additional advance care planning tools alongside it, but the ReSPECT form is primarily an English NHS framework. If a Welsh resident receives care at an English hospital (common along the border — Wrexham patients treated at Chester, for example), the English hospital may use a ReSPECT form instead.
Neither DNACPR nor ReSPECT replaces your ADRT. They're clinical tools designed to communicate your wishes quickly in emergencies, but they don't carry the same legal weight as a properly executed ADRT under the Mental Capacity Act 2005.
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Can You Request a DNACPR?
Yes. You can ask your GP or hospital consultant to discuss DNACPR and, if they agree it's clinically appropriate, complete the form. You can also state your CPR preferences in an ADRT, which the clinical team should then translate into a DNACPR form.
What you cannot do is demand a DNACPR unilaterally. It remains a clinical decision. However, if you have a valid ADRT that refuses CPR, the clinician's hands are tied — they must respect it regardless of their own clinical judgment.
The reverse is also true: a doctor can place a DNACPR on your notes even if you haven't asked for one, provided they've consulted you (or your family if you lack capacity) and documented the clinical reasoning. If you disagree with a DNACPR that's been placed without your knowledge, you have the right to challenge it through the NHS Wales complaints process — now governed by the "Listening to People" framework, which requires a face-to-face or virtual "listening discussion" and a 10-day early resolution window.
How to Ensure Your CPR Wishes Are Legally Protected
Relying solely on a DNACPR form is risky because it's a clinical opinion that can be reviewed, changed, or lost. A valid ADRT that explicitly refuses CPR is legally binding and cannot be overridden by a clinician's judgment.
Our Wales ADRT planning guide shows you how to draft a CPR refusal clause that meets the Mental Capacity Act 2005 requirements, coordinate it with a DNACPR discussion with your GP, and register both documents on the Welsh Clinical Portal.
Get the complete planning kit so your CPR decision is documented where it counts — legally, clinically, and physically.
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