Evidence on resource allocation in intensive care units

A summary of the international literature on ethical frameworks for resource allocation in intensive care units. This document incorporates a comparison of the NICE COVID-19 critical care guidance with other frameworks identified.

Overview of findings

All frameworks incorporate a short-term outcomes assessment. NICE guidance applies the Clinical Frailty Score (CFS), whereas most others use the Sequential Organ Failure Assessment (SOFA).

Some frameworks, including the NICE guidance, have been developed with input from key stakeholders, including lay members. There is general agreement that criteria should be objective and clinical. There is broad agreement that to provide most benefits for most people, it is necessary that treatment of the sickest people be limited in times of scarce resources. It is recognized that all patients still deserve the best care possible, including palliative care intended to reduce suffering.

Citing this report

This report should be cited as:

NIHR Applied Research Collaboration (ARC) North Thames and UCLPartners. Evidence on resource allocation in intensive care units. 26 March 2020. Available from https://arc-w.nihr.ac.uk/research-and-implementation/covid-19-response/reports/evidence-on-resource-allocation-in-intensive-care-units/