Where to Keep ADRT UK

A Valid ADRT Is Useless If Nobody Can Find It

An Advance Decision to Refuse Treatment has full legal force under the Mental Capacity Act 2005 — but only if the treating clinical team knows it exists and can access it during an emergency. There is no central registry for ADRTs in England. No national database. No automatic NHS record. Storage and distribution is entirely the individual's responsibility.

In practice, this means ADRTs that sit in a drawer at home, or locked in a solicitor's safe, often fail to reach the people who need to see them. When an ambulance crew responds to a collapse, or an A&E consultant makes treatment decisions at 3 AM, they work with whatever documents are on file at the hospital or flagged in the patient's GP records. If the ADRT is not there, they default to treating.

Register It With Your GP Surgery

This is the single most important storage step. Book a brief appointment or call the practice manager and ask them to:

1. Upload a copy to your electronic patient record. Most GP surgeries use either EMIS Web or SystmOne. Both systems allow documents to be scanned and attached to the patient's file, with a flag or alert that appears when the record is opened.
2. Flag it on your NHS Summary Care Record (SCR). The SCR is the system that hospital and out-of-hours doctors access in emergencies. Not all GP surgeries routinely flag ADRTs on the SCR, so you may need to ask specifically. The flag should read something like: "Patient has a valid ADRT — see attached document."
3. Give the GP a copy of any registered LPA as well. If you have a Health and Welfare LPA, the GP needs to know who your appointed attorneys are and whether the LPA or ADRT takes precedence (this depends on which document was created more recently).

Ask the GP surgery to confirm in writing that your ADRT has been uploaded and flagged. Do not assume this has happened — verify it at your next appointment by asking the GP to show you the alert on screen.

Distribute Certified Copies

Beyond the GP surgery, give copies to:

• Your appointed Health and Welfare attorneys (if you have an LPA). They need the ADRT so they can present it to clinical teams and understand the boundaries of their own authority.
• Close family members who are likely to be present during a medical emergency. Even if they are not your attorneys, they can hand the document to paramedics or hospital staff.
• Your regular hospital consultant if you are under ongoing specialist care. Ask them to upload it to the hospital trust's electronic health record.
• Your care home if you live in one, or if a move is being planned. The care home's records should include both the ADRT and the LPA.

Keep the signed original in a secure but accessible location at home — a fireproof document box is better than a locked safe that your attorneys cannot open in an emergency.

The Emergency Access Problem

The gap in England's system is acute emergencies where the patient arrives unconscious at an unfamiliar hospital. If the A&E team has no access to the patient's GP records and no family member is present to hand over the document, the ADRT effectively does not exist for that admission.

There are a few partial solutions:

• A medical alert bracelet or wallet card that states you have an ADRT and lists emergency contact numbers for your attorneys. Paramedics are trained to check for these. The card should read: "I have an active ADRT and Health and Welfare LPA. Contact my GP surgery or my attorneys immediately."
• A digital copy on your phone. Some NHS trusts are beginning to accept digital documents shown by family members, though the legal position on digital copies versus signed originals remains unclear for life-sustaining treatment refusals.
• Compassion in Dying's free ADRT registration service stores a copy and can send it to your GP, but they cannot guarantee real-time access during an emergency admission.

None of these methods is foolproof. The most reliable protection is redundancy — multiple copies in multiple locations, with every relevant healthcare provider holding a copy before a crisis occurs.

Review and Re-Verify Annually

Documents get lost in system migrations, GP practice mergers, and staff turnover. Once a year — perhaps during a routine health check — ask your GP surgery to confirm that your ADRT is still flagged on your record and that the uploaded copy matches your current version.

If you have updated your ADRT since the last version on file, physically destroy old copies and replace them everywhere. An outdated ADRT that contradicts your current wishes can create clinical confusion and legal disputes.

Our England Advance Directive guide includes a document storage log and distribution tracker — a simple record of who holds which version, when it was delivered, and when to re-verify.

See more England guides →