The new palliative care gold standard
By: Julia Riley
The EIU’s recent Quality of Death report praised palliative care in the UK as the best in the world, citing the quality and availability of services provided by the NHS and hospice movement as “second to none”. Nonetheless, the report highlighted room for improvement, echoing findings of the Parliamentary and Health Service Ombudsman in England that criticised end-of-life care services.
We need to address the points that have been highlighted as areas for improvement, including better availability of out-of-hours cover, more flexible services and more responsive services. How do we do this when expectations are higher than ever, NHS resources are stretched and the “out of hours” period is two-thirds of the week?
In my mind, there is only one solution: Advance Care Plans (ACP), and the communication and sharing of these plans digitally with the urgent care services that operate 24/7. Creating ACPs enables patients to take control and make choices with their usual doctor and nurse. Through the sharing of this information with the urgent care providers, the right care can be provided, at the right time, in the right place—24/7.
Across London this work has already begun, with an innovative NHS service called Coordinate My Care (CMC). This coordinates the care of patients and provides them with choice and the assurance that all the healthcare professional teams involved in their care are connected and mindful of these choices, whenever they are treated.
A digital, personalised urgent care plan underpins the service. This documents a patient’s views and wishes, and can be seen by the entire multidisciplinary team involved in their care, 24/7.
The priority of CMC is to support and facilitate the provision of integrated health and social care by bridging the divide between community, acute and urgent care settings, with integration of the voluntary sector. CMC integrates care across London both in and out-of-hours, including GPs, community nurses, community palliative care teams, hospitals, hospices, social workers, the London Ambulance Service, NHS 111 and nursing/care homes.
To date, 24,676 CMC personalised urgent care plans have been created for patients. I strongly believe this model is the next phase in palliative and urgent care provision excellence. Online banking and the ATM and have given us 24/7 access to our finances. Digital ACPs could be the answer to flexible, 24/7 patient care.