1. Sarah Bogle: TEPs Project Manager
Treatment Escalation Plans (TEPs): Recording Decision-making for an emergency
Prof Alison Richardson: Clinical Professor of Cancer Nursing and End of Life Cafe
Sarah Bogle: TEPs Project Manager
Collaboration for Leadership in Applied Health Research and Care (Wessex)

2. Why is TEP needed?
DNACPR process has its limitations: a negative withholding of treatment not an overall plan for treatment
Decisions and plans made too late in the day for many
Encourage and trigger an important conversation earlier
Only 4% have treatment plans when they die currently
Importance of shared decision-making between patient (and next of kin) and the clinician
Local TEPs have been generated, e.g. Devon TEP since 2006, Cambridge UFTO
Many national reports and committees recommending action
Court judgments, e.g. Tracey, Winspear
Mentions some reports

3. What is TEP? My wishes are respected if I my health deteriorates
Treatment plan in an emergency
Avoid confusion and distress in emergency situations
Capture priorities and goals of care
Ceilings of treatment at end of life
Shared decision-making
A difficult but important conversation between patient and clinician
A summary record for all care settings

4. National Working Group
Emergency Care and Treatment Plan (ECTP) – the title may change
National form and process for all of UK and all age groups
Treatment options that include decision on CPR
Co-chaired by Resuscitation Council (UK) and Royal College of Nursing
Formed in February 2015
Consultation January-February 2016
Current activities: review of consultation feedback, communications planning, further engagement, pilots in different settings
Plan to launch by November 2016
Implementation approach most likely to be ‘over to you’ to lead locally

5. Questions for you Who might need one?
Who might start the conversation?
What should happen when it is completed?