Luton and Dunstable University Hospital NHS Foundation Trust

4. Mrs A complains about the care and treatment her father had from the Trust in April 2022. She says it did not see that Mr Y had a do not attempt cardiopulmonary resuscitation (DNACPR) order in place, so gave chest compressions for nine minutes against his wishes.

5. Mrs A explains that as a result, Mr Y experienced severe distress in the last hours of his life. Mrs A says she witnessed her father in a state of agitation and distress and he died in an undignified way that was totally avoidable. She says it has caused much emotional and psychological pain to her, her brother and mother.

6. Mrs A wants the Trust to make service improvements.

8. Before we decide if we should do a detailed investigation of a complaint, we look at whether there are signs the events complained about had a negative effect that the organisation has not put right.

9. Mrs A explained she would like the Trust to make service improvements to reduce the chance of this happening to someone else.

10. We looked closely at Mrs A’s complaint and the outcomes she wants. We contacted the Trust to see if it was willing to agree to Mrs A’s outcomes.

11. After discussions with the Trust it has agreed to rewrite the Urgent Emergency Care document. It will introduce a checklist to include checking for DNACPR. Its new procedure also includes discussing DNACPR orders with all clinicians.

12. We shared this with Mrs A and she told us the new process would resolve her complaint.

13. We consider this agreed resolution meets Mrs A’s outcomes and we do not need to take any further action.

14. We realise how difficult and upsetting this has been for Mrs A and we thank her for bringing her complaint to us.

1. We have carefully considered Miss A’s complaint about Luton and Dunstable University Hospital NHS Foundation Trust (the Trust).

2. We recognise how difficult it has been for Mrs A since the death of her father, Mr Y.

3. The Trust has explained service improvements it will make as an outcome of Mrs A’s complaint. Mrs A told us this will resolve her complaint.