GPs are explaining that ventilation and CPAP pressurised oxygen masks “may not be available to them” and their family and friends “would not be able to visit”.
They are also being advised that CPR chest compressions, used when a patient suffers cardiac arrest, are a “very aggressive” intervention and their quality of life may be significantly reduced if they survive.
The advice is included in guidance drawn up for GPs in eight central and north-west London boroughs to follow if a patient agrees to have a conversation about future care.
They insisted these were not “forced discussions” and only continued if the patient consented.
Dr Neville Purssell, a GP in Paddington and chairman of the central London clinical commission group, said patients who drew up a care plan in consultation with their family doctor were more likely to have their wishes followed if they fell seriously ill. Care plans are not new but the epidemic, from which frail, elderly people are at significantly higher risk, has created the need for more people to consider where and how they wish to die.
It can enable them to remain in their care home and receive pain relief and have a “natural death”.
Dr Purssell said the guidance came in last week to help GPs with “difficult conversations”. It draws on national guidance from the National Institute for Health and Care Excellence and the Royal College of GPs.
He told the Standard: “In the current context of the Covid-19 situation, it’s sadly very possible that some of our residents in care homes and our frail patients may become unwell. So we really want to have these advance care plans in place…
“What we don’t want is perhaps people who really do not want to go to hospital to be taken to hospital because [other] people are worried.”
The 200-page guidance is for the North West London Health and Care Partnership, covering 2.4 million people.
It is not known how many deaths there have been in London care homes. One facility in Glasgow reportedly had 13 residents die with coronavirus last week.