December 18, 2020

Core end of life is the epaccs clinicians ‘always wanted’

Our end of life care plan has been praised for reducing the stress on both clinicians and patients by giving them the live palliative information they need when they need it most.

GPs and technical leads said our Electronic Palliative Care Co-ordination System (EPaCCS) instantly made a “big difference” across Humber Coast and Vale Integrated Care System (ICS).

People with 12 months left to live are put onto an end of life care plan to ensure they live as well as they can and die with dignity.

EPaCCS is a digital version of this plan which should give all relevant clinicians the patient’s up to date preferences in both their care and where they would like to die.

But often the healthcare professional with them at the critical time does not know or have access to these wishes in an authoritative single shared care record. This can be because the information is out of date, or is not shared with every relevant user in an easy-to-access format.

Humber Coast and Vale were looking to build their own plan – HCV EPaCCS – and chose ours as it allows each health and care organisation to work off the same live record.

Core End of Life lets any relevant health and care professional create a care plan in under 60 seconds which is instantly shared with every appropriate service.

All the data is live and if the patient changes their wishes or a clinician updates their status everyone is instantly notified.

Humber Coast and Vale ICS said the fact this information was readily available in a clear format “24/7” was “key” to the pilot phase’s success across three CCGs.

HCV EPaCCS is now going live in the remaining CCGs following “huge enthusiasm” from the clinicians who used it in hospitals, hospices, GP practices, community nursing teams, out of hours surgeries and NHS 111.

The GPs and technical leads who piloted it told how successful the plan has been in an interview here.

Dr Dan Cottingham, MacMillan GP and End of Life lead for Vale of York CCG, said: “The big sell for this system is the clinicians wanted it already.

“I have been a GP for 20 years plus and I have wanted something like this for as long as I have practiced.”

Listing off some of the benefits of enhanced interoperability, Dr Cottingham described how HCV EPaCCS was helping patients in the emergency department.

He said:

“Although we’re not wanting these patients to end up in the emergency department, the fact they had an EPaCCS when they came made a big difference.
“They knew what that patient needed and were able to set things up in order to get them home. So it speeded that process up.”

Dr Cottingham said how patients not having to repeat their story was a huge help to both patients and clinicians.

He added:

“The fact that you know that the feeling of care is to keep them at home, to keep them comfortable, and the fact you know the relatives know that too from the EPaCCS, really makes a difference.”

Debbie Westmoreland, senior service development manager for NHS North Yorkshire CCG, said HCV ICS went with our solution because it shared everything that you need in real time.

She said it was “really important” that they had “a composite record that could be created and updated by different organisations, but still be visible to all of them.”

Debbie continued:

“There were lots of ways to share bits of information across our system already in place, but there wasn’t a way of sharing everything across all the organisations that truly needed to be engaged with that patient at that point.”

She said the “key thing” was that our records were “available to them 24/7” and also highlighted its ability to “pre-populate” information including preferred place of care and CPR decision.

Debbie said:

“It hasn’t been the hardest sell.
“There aren’t many who could or would disagree with the value of standardised End of Life information being made available at key times to reduce stress to patients, carers, but also the professionals trying their best to manage that patient’s experience at such a sensitive time.
“Without that information there when they need it, the pressure on them is really difficult to make those decisions.”

Describing how clinicians have taken to HCV EPaCCS, Debbie said:

“Once the clinical benefits and the anecdotal achievements had started to trickle through and feedback started to surface it helped build momentum.
“What we didn’t find a challenge was there was huge enthusiasm for this. There was an absolute case for it. It wasn’t something hard to buy into, it wasn’t something hard to promote.”

John Mitchell, Associate Director of IT for the CCGs across the Humber, said we “ticked a number of boxes off the shelf” which got them some “really quick wins”.

He said our existing integrations with clinical systems including EMIS and SystmOne, as well as Black Pear being interoperable with Adastra, meant clinicians could reap the benefits of more connected healthcare almost immediately.

Dr Jenni Lawrence, Macmillan GP for Scarborough and Ryedale CCG, also described how it has benefited her as an Out of Hours GP.

She said having access to a cancer patient’s EPaCCS record meant they could get care where they wanted it, adding: “I am seeing the benefit of this with every shift I work out of hours.”

Dr Lawrence told how it helped her when the laboratory reported a patient for having a low haemoglobin and becoming anaemic.

Normally this would see the doctor admitting her, but she said:

“The fact that I could see her EPaCCS and know that she wanted to be cared for at home, and know that she wanted to ultimately die at home, meant … I could leave the patient at home safe in the knowledge that this was her wish”.

To find out more about our care plans click here.

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