NHS empowers patients to record and share urgent and end-of-life care preferences

NHS Coordinate My Care clinical service launches online ‘myCMC’ enabling patients to create their own urgent care plans

Patients across Greater London are to be given increased power to inform clinical staff of their wishes following the launch of a new online urgent care record.

Coordinate My Care (CMC), an NHS clinical service, has launched the myCMC patient portal, which enables patients to go online and easily initiate their own urgent care plans.

Through this, patients can let GPs, hospitals, ambulance crews, 111 providers, care homes, hospices and out-of-hours services know about their urgent and end-of-life care wishes. They can specify the treatment they want, and where and when they want it, should their condition deteriorate. They can also detail their key contact information and document if they would like their organs donated.

Poor coordination of records across health and social care can often make it difficult to know when and how to do the right thing, creating a lot of pressure for professionals and patients

Information will include whether the patient wants to be taken to hospital, their resuscitation wishes, and their preferred place of death.

Professor Julia Riley, clinical lead at Coordinate My Care, said: “Empowering patients to tell NHS and care providers the care they want to receive at a crucial point of their life is a priority.

“As care providers we have a responsibility to co-ordinate our services around patient wishes – especially when they are faced with difficult diagnoses that may require urgent or end-of-life care.

“CMC has already had a big impact for many patients, but there are many more who are still inappropriately sent to hospital when they do not want to be there, causing distress for patients and pressure on the system.

“MyCMC is accessible online and will allow many more patients, families and carers, to set up plans that can make a huge difference to their experience.”

Less than one in five patients with a plan spend their last days in hospital, compared to almost 50% nationally, which, in addition to respecting patient wishes, is saving the NHS an average of £2,100 per patient, according to CMC.

The new online service will enable patients to make their wishes known to healthcare professionals

More than 46,000 CMC plans have so far been created for patients and the portal launch is expected to see significantly more plans created, while reducing the burdens faced by healthcare professionals.

The myCMC development is built on InterSystems’ unified health informatics platform, HealthShare. It has been designed to be intuitive, having been developed in consultation with healthcare professionals.

Dr Naz Jivani, a GP in New Malden, said: “Creating an action plan for patients whose condition might escalate means we can ensure they are appropriately treated and avoid unnecessary hospital admissions.

Working with patients at the coalface to understand their wants and needs in advance allows out-of-hours services to come to a very-quick decision on the most-appropriate care for that patient in the event of deterioration

“Frail patients who may be coming toward the end of their life, often do not want to be sent to A&E; they prefer to be treated in their home or care home. But, where plans are not in place, staff and carers can panic without the right information and send patients to hospital for events that may be part of the natural process of dying, sometimes leading to patient distress or people spending their final hours in A&E.

“Working with patients at the coalface to understand their wants and needs in advance allows out-of-hours services to come to a very-quick decision on the most-appropriate care for that patient in the event of deterioration.”

And Tracey Bleakley, chief executive of Hospice UK, added: “Giving patients and their families the means to plan for end of life and urgent care is critical and there is clear public demand.

“Poor coordination of records across health and social care can often make it difficult to know when and how to do the right thing, creating a lot of pressure for professionals and patients.

“CMC plans can make sure important questions and discussions about the patient’s wishes are not overlooked. And they can help professionals to understand when it is not appropriate to take patients to hospital where they may feel frightened or when to avoid resuscitation and the unintended consequences of cracked ribs or severe pain often associated.

“People want to be involved in the decisions about their care. Creating a CMC urgent care plan is something that stimulates discussion and gives patients control.”

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