Patients Wills Policy

Transcription

1 Trust Policy and Procedure Document Ref. No: PP(016)052 Patients Wills Policy For use in: For use by: For use for: Document owner: Status: All wards Medical, Nursing and Operational Staff Management Of Patients Requests To Make A Will Information Governance & Legal Services Manager Draft Contents Page No. 1 INTRODUCTION 2 2 PATIENT S REQUEST TO MAKE A WILL 2 3 WITNESSES 2 4 VALIDITY OF WILL 2 5 PATIENT S RECORDS 3 6 EMERGENCIES 3 7 ADVANCE DECISION (LIVING WILL) 4 8 MONITORING 5 9 REVIEW 5 APPENDIX A APPENDIX B APPENDIX C SAMPLE OF EMERGENCY WILL FORM SAMPLE OF ADVANCE DECISION KPIs Purpose of this Document To provide guidance on assisting patients who request to make a will whilst in the Trust s care. Aims To advise Trust staff on practical and legal arrangements for preparation of a patient s will. Source: IG & Legal Services Manager Status: Draft Page 1 of 8

2 1 INTRODUCTION For a will to be valid it must be in writing (or typewritten) signed by the patient making the will (or by an individual that the patient has identified to sign in his/her presence and under his/her direction). the patient s signature must be made (or acknowledged by the patient) before at least two witnesses at the same time as the will is signed by these two witnesses. 2. PATIENT S REQUEST TO MAKE A WILL If a patient requests to make a will he/she should be advised to contact a solicitor. Nursing staff should ensure that appropriate arrangements are made for the solicitor to visit the patient irrespective of visiting times. 3. WITNESSES If staff are asked to assist as witnesses, two witnesses must be present (Senior Nurse or Duty Manager to arrange this). Witnesses must not be beneficiaries under the will; witnesses should be completely independent and not the nurses involved in the individual s care. The Patient Affairs Officer is usually involved when a witness is required. Occasionally, the Cashiers/PALS Manager may be asked to witness wills if the Patient Affairs Officer is not available If a request to witness a will comes from anyone other than the solicitor, the patient should be advised to take legal advice. The advice should be documented. Any request to witness a will must be recorded in the patient s notes and signed by the appropriate member(s) of staff. It is particularly important to record the refusal to witness a statement if this situation arises. A statement could be inserted as follows: apart from satisfying myself that. (name of patient) knew he/she was signing his/her name and I was witnessing it, I did not assess. (name of patient) for mental competence and I explained this to the patient and to.. (names of any other people) who were also present. 4. VALIDITY OF WILL No member of staff can be made to witness a will. A member of staff should not witness a patient s will unless he/she believes the patient understands what he/she is doing and is doing so entirely voluntarily. A doctor at the level of consultant should assess the patient s capacity for these purposes. They should document in the medical record that they have assessed for the purposes of will making and that they deem them fit to make decisions about their affairs. Source: IG & Legal Services Manager Status: Draft Page 2 of 8

3 Also, if it is believed the patient is not preparing his/her will voluntarily, appropriate action should be taken as outlined in the policy on Safeguarding Vulnerable Adults at Risk of Abuse. 5. EMERGENCIES In case of emergency during the night, both witnesses should be of a senior grade (e.g. Site Manager) If there is no time to send for a solicitor, the patient should be assisted in making a simple will. Appendix A is a sample of a form that can be used. Such a will should only be completed by a Service Manager/Senior Nurse/Site Manager On-call on duty at the time and not by ward staff. It is preferable that staff do not get involved in assisting with a will. The Site Manager should be contacted and endeavour to contact the Trust s solicitors out of office service. 6. ADVANCE DECISIONS An Advance Decision is a statement made by a mentally competent person of 18 years or over, which defines in advance their refusal of medical treatment should they become mentally or physically incapable of making their wishes known. An Advance Decision does not operate if a patient is conscious or competent. It is a patient s responsibility to let the hospital know if an Advance Decision is applicable to his/her care. In this respect, it is anticipated that an Advance Decision form will already have been completed. An Advance Decision should be clearly documented in the patient s medical and nursing notes. It should be filed under the ID Sheet in the medical notes and an alert sticker placed on the front of the folder. The Alert should also be entered on PAS. All members of the clinical team should be aware of this documentation. Whilst relatives may be asked to confirm the patient s wishes and provide a copy of the form if not already documented in the notes, relatives have no legal status in decision-making for an incapacitated patient. Source: IG & Legal Services Manager Status: Draft Page 3 of 8

4 Activating an Advance Decision Check a copy of the Advance Decision form is filed in the notes. Check the date and validity of the Advance Decision - this may require the Consultant in charge of the patient contacting his/her GP and/or obtaining Legal advice from the Trust s solicitors. An Advance Decision only prevents life-sustaining treatment if it is: (a) in writing, and (b) says in substance that it applies even if the patient s life is at risk, and (c) was signed by the patient or another person in his presence and at his direction, and (d) the signature was made or acknowledged by the patient in the presence of a witness, and (e) the witness signed the Advance Decision, or acknowledged his signature to it, in the patient s presence. All decisions taken relating to the Advance Decision must be clearly documented in the clinical records. If any staff object to complying with the patient s Advance Decision, the Manager should be notified immediately and the care of the patient transferred to another member of staff. Provide relatives with up-to-date information on the legal status of the Advance Decision. Give relatives an opportunity to discuss the issues with an appropriate member of staff. Assisting a patient to prepare an Advance Decision It is anticipated that an Advance Decision will have been prepared prior to the patient s admission to hospital. If this is not the case, and a patient asks how to go about preparing an Advance Decision, provide the patient with a copy of the sample form (Appendix B). Suggest that the patient discuss the situation with his/her solicitor to ensure all legal issues are taken into account. Document clearly in the patient s notes the request received and advice given. Source: IG & Legal Services Manager Status: Draft Page 4 of 8

5 7. MONITORING The effectiveness of this policy will be monitored through the Trust s Incidents Policy (PP105) and Complaints Policy (PP002). Trends of non-compliance will be identified from the Risk Officer s quarterly reviews of incidents and complaints. The policy and its application will be reviewed as necessary and action taken to ensure the guidance for staff and patients is understood and adhered to. This will be achieved through reporting against defined key performance indicators as part of the policy review process (these KPIs are detailed in Appendix C) 8. REVIEW This policy will be reviewed every two years or as National or local changes in policy dictate. Author: Sara Ames, IG & Legal Services Manager Other Contributors Operational and Nurse Managers Approval and Endorsements: Nursing & Midwifery Practices and Policies Group Issue No: 6 File Name: PATIENTS WILLS Supercedes: PP(13)052 Equality assessed Implementation Monitoring Other relevant policies/documents and references Additional Information: Yes Trust-wide circulation See (8) above None To be reviewed as legislation dictates Source: IG & Legal Services Manager Status: Draft Page 5 of 8

6 APPENDIX A - SAMPLE ONLY WILL MUST BE HANDWRITTEN OR TYPED. THIS CANNOT BE USED AS AN ORIGINAL EMERGENCY WILL FORM I.. of. hereby revoke all former Wills and testamentary dispositions made by me and declare this to be my last Will. I devise and bequeath all my real and personal estate NOTE:* (i) Define the Beneficiaries by name. Avoid terms such as my children, etc. to * (ii) equally between One Executor is sufficient. *(iii) as follows absolutely and appoint of sole executor/s of this my Will. In witness whereof, I have hereunto set my hand this day of 20. Signed by the above named as his/her last Will in the presence ) of us, both present at the same time, ) who at his/her request and in the ) (Signed) presence of each other have hereunto ) subscribed our names as witnesses. ) Name, Address and Description of Witness Name, Address and Description of Witness Source: IG & Legal Services Manager Status: Draft Page 6 of 8

7 APPENDIX B ADVANCE DIRECTIVE (LIVING WILL) I, (name) of (address) If ever I am unable to communicate and have an irreversible condition (see schedule below) and I am expected to die in a matter of days or weeks, or if I am in a coma and not expected to regain consciousness or if I have brain damage of disease that makes me unlikely ever to recognise or relate to people then I want treatment only to provide comfort and relieve distress, even if this may shorten my life. I do not want treatment that can only prolong dying. I consent to any acts or omissions undertaken in accordance with my wishes and I am grateful to those who respect my free choice. I reserve the right to revoke or vary these conditions but otherwise they remain in force. If I am certified brain dead, should any of my organs be of value to others, I give consent to their removal for the purpose of transplantation. SCHEDULE A B C D E F Advanced disseminated malignant disease (eg cancer). Severe immune deficiency Advanced degenerative disease of the nervous system. Severe and lasting brain damage due to injury, stroke, disease or other cause. Senile or pre-senile dementia. Constant, uncontrolled pain. Signed Date WE TESTIFY that the maker of this Directive signed it in our presence, and made it clear to us that he/she understood what it meant. We do not know of any pressure being brought on him/her to make such a directive and we believe it is his/her own wish. So far as we are aware we do not stand to gain from his/her death. Witnessed by: Signature: Name: Address: Signature: Name: Address: Source: IG & Legal Services Manager Status: Draft Page 7 of 8

8 APPENDIX C Key performance indicators (KPIs) Summary of the key measures for assessing management of this area of responsibility and progress in delivery of the development plan Activity Description of area of measurement Request from patient to have assistance with will Key performance indicator (KPI) Description of performance measure(s) for this area To be acknowledged and assistance sought within 12 hours Target/measure Describe target or source of measurement Target 100% If Legal Assistance requested Emergency assistance To be obtained within 24 hours Target 100% No delay Target 100% No. of complaints from patient and family Review of incidents and complaints data on a quarterly basis Nil complaints Advance Decision clearly marked on patients records as necessary Clearly visible when required Target 100% Source: IG & Legal Services Manager Status: Draft Page 8 of 8