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Advance Decision Notification And Copy Holders In The United Kingdom

Created:
This structured dataset helps readers understand who should be notified about an advance decision and who may hold copies. It is useful for planning, sharing, and keeping healthcare wishes accessible. For related resources, visit AI Generated British Advance Decision.
Contact role
Reason for notifying
May hold copy
Notification timing
Healthcare professional
GP practice
To record the Advance Decision and provide it in an emergency.
true
At creation
After signing
After a review
After a major health change
If preferences change
Hospital consultant
To consider treatment refusals during specialist care.
true
After signing
After a review
After a major health change
If preferences change
Hospital admissions or ward team
To place the document on hospital records during admission.
true
After signing
After a major health change
If preferences change
Emergency contact
Local ambulance service
To alert emergency clinicians to treatment refusals.
true
After signing
After a review
After a major health change
If preferences change
Paramedics attending an emergency
To identify binding treatment refusals during emergency care.
false
After signing
After a major health change
If preferences change
Family or personal contact, Legal professional
Health and welfare LPA attorney
To coordinate decisions within attorney authority.
true
At creation
After signing
After a review
After a major health change
If preferences change
Proposed health and welfare attorney
To understand future treatment preferences before appointment.
true
At creation
After signing
If preferences change
Family or personal contact, Emergency contact
Next of kin
To help clinicians find the document quickly.
true
At creation
After signing
After a review
After a major health change
If preferences change
Spouse or civil partner
To alert healthcare staff if capacity is lost.
true
At creation
After signing
After a review
After a major health change
If preferences change
Family or personal contact
Adult children
To avoid confusion about treatment wishes.
true
At creation
After signing
After a review
After a major health change
If preferences change
Parents
To explain wishes and document location.
true
At creation
After signing
After a review
If preferences change
Siblings
To help locate the document if relatives are contacted.
true
At creation
After signing
After a review
If preferences change
Family or personal contact, Emergency contact
Trusted friend
To provide backup access to the signed document.
true
At creation
After signing
After a review
If preferences change
Emergency contact, Family or personal contact
Named emergency contact
To signpost clinicians to the Advance Decision.
true
At creation
After signing
After a review
After a major health change
If preferences change
Care provider
Care home manager
To keep the document accessible in care records.
true
After signing
After a review
After a major health change
If preferences change
Care provider, Healthcare professional
Nursing home clinical lead
To guide nursing escalation and treatment decisions.
true
After signing
After a review
After a major health change
If preferences change
Care provider
Home care agency
To know who to contact if health deteriorates.
true
After signing
After a review
After a major health change
If preferences change
Care provider, Emergency contact
Live-in carer or personal assistant
To locate the document during a home emergency.
true
After signing
After a review
After a major health change
If preferences change
Healthcare professional
District nursing team
To support home-based care consistent with refusals.
true
After signing
After a review
After a major health change
If preferences change
Healthcare professional, Care provider
Community matron or case manager
To coordinate care plans and escalation instructions.
true
After signing
After a review
After a major health change
If preferences change
Healthcare professional
Palliative care team
To align symptom care with treatment refusals.
true
After signing
After a review
After a major health change
If preferences change
Healthcare professional, Care provider
Hospice team
To apply refusals during hospice care.
true
After signing
After a review
After a major health change
If preferences change
Mental health care coordinator
To understand capacity-related treatment refusals.
true
After signing
After a review
After a major health change
If preferences change
Healthcare professional
Psychiatrist
To consider refusals when assessing capacity and treatment.
true
After signing
After a review
After a major health change
If preferences change
Legal professional
Solicitor who prepared the document
To retain drafting records and confirm latest version.
true
At creation
After signing
After a review
If preferences change
Private client solicitor
To store the signed version with estate planning papers.
true
After signing
After a review
If preferences change
Legal professional, Family or personal contact
Court of Protection deputy
To understand existing treatment refusals and best interests context.
true
After signing
After a review
After a major health change
If preferences change
Official body, Care provider
Independent Mental Capacity Advocate
To inform serious medical treatment advocacy.
true
After signing
After a review
After a major health change
If preferences change
Local authority adult social care
To include document details in care assessments and plans.
true
After signing
After a review
After a major health change
If preferences change
Official body, Healthcare professional
NHS continuing healthcare team
To reflect refusals in funded care planning.
true
After signing
After a review
After a major health change
If preferences change
Local NHS shared care record team
To add a note or copy to shared records if available.
true
After signing
After a review
If preferences change
Official body
Office of the Public Guardian
Relevant if attorney powers or LPA records need clarification.
false
After signing
If preferences change
Emergency contact, Healthcare professional
NHS 111 urgent care service
To mention the document during urgent care triage.
false
After signing
After a major health change
If preferences change
Healthcare professional, Emergency contact
Out-of-hours GP service
To ensure urgent clinicians know a signed copy exists.
false
After signing
After a major health change
If preferences change
Emergency department
To apply the refusal during acute treatment decisions.
true
After signing
After a major health change
If preferences change
Healthcare professional
Anaesthetist or surgical team
To assess refusals before surgery or anaesthesia.
true
After signing
After a review
After a major health change
If preferences change
Intensive care team
To consider refusals of ventilation or resuscitation.
true
After signing
After a review
After a major health change
If preferences change
Cardiology team
To note refusals relevant to heart treatment or resuscitation.
true
After signing
After a review
After a major health change
If preferences change
Oncology team
To record refusals relevant to cancer treatment escalation.
true
After signing
After a review
After a major health change
If preferences change
Renal team
To document any refusal of dialysis or escalation.
true
After signing
After a review
After a major health change
If preferences change
Respiratory team
To record refusals of ventilation or intensive support.
true
After signing
After a review
After a major health change
If preferences change
Neurologist
To note refusals linked to neurological decline.
true
After signing
After a review
After a major health change
If preferences change
Healthcare professional, Care provider
Dementia care team
To preserve treatment wishes before capacity is lost.
true
At creation
After signing
After a review
After a major health change
If preferences change
Learning disability team
To support accessible communication about treatment refusals.
true
At creation
After signing
After a review
After a major health change
If preferences change
Healthcare professional
Regular pharmacist
To note relevant refusals when advising on medicines.
false
After signing
After a major health change
If preferences change
Dentist or oral surgeon
To note refusals relevant to treatment or sedation.
true
After signing
After a review
If preferences change
Family or personal contact, Care provider
Faith leader or chaplain
To support family communication about values and wishes.
false
At creation
After signing
If preferences change
Healthcare professional, Care provider
Occupational health provider
To signpost emergency responders if a workplace crisis occurs.
false
After signing
After a major health change
If preferences change
Care provider, Emergency contact
Education setting medical support
To know who holds the document during an on-site emergency.
false
After signing
After a major health change
If preferences change
Family or personal contact, Emergency contact
Travel companion
To carry details when away from usual records.
true
After signing
After a review
After a major health change
If preferences change
Emergency contact, Care provider
Medical alert service
To display document existence or emergency contact details.
false
After signing
After a review
After a major health change
If preferences change
Care provider, Official body
Secure document storage provider
To ensure nominated people can access the latest copy.
true
After signing
After a review
If preferences change
Family or personal contact, Legal professional
Executor or personal representative
To know where healthcare planning papers are stored.
true
After signing
After a review
If preferences change
Family or personal contact, Legal professional, Official body
Welfare guardian in Scotland
To understand welfare powers and prior treatment refusals.
true
After signing
After a review
After a major health change
If preferences change
Healthcare professional
GP practice in Scotland
To record the Advance Directive in Scottish medical records.
true
After signing
After a review
After a major health change
If preferences change
GP practice in Northern Ireland
To record the document in Northern Ireland health records.
true
After signing
After a review
After a major health change
If preferences change
GP practice in Wales
To record the Advance Decision in Welsh health records.
true
After signing
After a review
After a major health change
If preferences change
Official body, Legal professional
Mental Capacity Act 2005 compliance note
Life-sustaining treatment refusals must satisfy statutory formalities.
false
At creation
After signing
After a review
If preferences change
Official body, Legal professional, Healthcare professional
Mental Capacity Act Code of Practice guidance
To guide professionals on validity and applicability.
false
At creation
After a review
If preferences change
Official body, Healthcare professional
Hospital records department
To upload or index the signed copy in patient records.
true
After signing
After a review
If preferences change
Healthcare professional, Care provider
ReSPECT plan coordinator
To align emergency care recommendations with refusals.
true
After signing
After a review
After a major health change
If preferences change
Healthcare professional, Care provider, Emergency contact
DNACPR form holder
To avoid inconsistency between DNACPR and Advance Decision records.
true
After signing
After a review
After a major health change
If preferences change
Legal professional
Will writer or estate planner
To keep location details with other planning documents.
true
After signing
After a review
If preferences change
Family or personal contact, Legal professional
Signing witness
To evidence signature formalities if validity is questioned.
true
After signing
If preferences change
Person signing on maker's behalf
To evidence authorised signing if the maker cannot sign.
true
After signing
If preferences change
Property and financial affairs attorney
To know location of papers, not to make health decisions.
true
After signing
After a review
If preferences change
Official body, Healthcare professional
NHS App or GP online records access
To check whether the document note is visible in records.
false
After signing
After a review
If preferences change
Family or personal contact, Care provider
Family mediator or counsellor
To reduce disputes about known wishes.
false
At creation
After signing
If preferences change

Who Should Be Told About An Advance Decision In The UK?

Tell the people most likely to be involved in urgent treatment decisions, including your GP, hospital team, attorney under a health and welfare LPA, next of kin, care home or care agency, and key family contacts. An Advance Decision is most useful if clinicians can find it quickly when you lack capacity.

Who Should Hold A Copy Of An Advance Decision?

Common copy holders include your GP, attorney, hospital consultant, care home, and trusted family members. If the Advance Decision refuses life-sustaining treatment, it must meet the Mental Capacity Act 2005 requirements, including being in writing, signed, witnessed, and stating that it applies even if life is at risk.

When Should Copies Be Updated?

  • After signing: send the signed version, not a draft, to key contacts.
  • After a review or preference change: replace old copies so nobody relies on outdated instructions.
  • After a major health change: notify the GP, specialists, care providers and attorneys because treatment decisions may become more likely or more specific.
  • During a hospital admission or care move: make sure the admissions team or care provider records that an Advance Decision exists and where a copy is kept.

Does Everyone Need The Same Information?

No. Some contacts only need to know that the document exists and where to find it, while others may need a full copy. For example, emergency contacts and family may help alert clinicians, but healthcare professionals and care providers usually need the actual signed copy to apply it safely.

Advance Decision Notification and Copy Holders
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FAQs

People who may need to know about an Advance Decision include your GP, hospital consultants, care home, attorney under a health and welfare Lasting Power of Attorney, close family, carers and anyone likely to be contacted in a medical emergency.
Show All FAQs

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References and Information Sources