Digital end of life care plans rolled out to 100,000 patients

Five integrated care systems (ICSs) have adopted a digital forms detailing patients’ end of life care recommendations, following a widescale rollout.

The Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) form details personalised recommendations for clinical care and treatment in the event of a patient not being able to communicate this for themselves, including what matters most to the patient, as well as what is realistic in terms of their care and treatment.

More than 100,000 people can now access digital versions of ResPECT or end of life care forms, which were rolled out using the NHS’s CIPHA platform, a combined population health, single patient record, pathway, analytics and remote monitoring system, supplied by Graphnet Health.

The Nuffield Trust has estimated the cost of caring for patients in their last year of life at £22bn annually and the initiative is expected to support patients and relatives during a stressful time.

Markus Bolton, director at Graphnet Health, said: “The NHS has been wrestling with the deployment of digitized end of life plans for decades and I am delighted that we are finally able to roll out a solution at scale.

“It is CIPHA’s combination of shared care record, analytics, population health, workflow and forms along with the widespread use of the system which have made this possible.

“Population health is at the forefront of the drive towards more personalized, joined up and compassionate care and I look forward to a time when anyone that needs an end-of-life plan has one.”

The ReSPECT and end of life systems are currently used by Bath, North East Somerset, Swindon and Wiltshire (BSW), Kent, Northamptonshire, Staffordshire and Greater Manchester ICSs.

Subject to further funding, the programme will be extended across the wider CIPHA user base, supporting accessible end-of-life plans for more than 300,000 people.

The digital ReSPECT solution pulls in clinical data from across the shared care record and allows clinicians and patients to add personalised recommendations for emergency care and treatment – including decisions around CPR.

Because the digital version is embedded directly into the shared care record, patient preferences are accessible in real time across the health and care system, meaning that ambulance dispatchers, paramedics, or emergency department clinicians can access a patient’s wishes and clinical recommendations.

Claire Mansfield, Macmillan palliative and end of life care transformational leader at Integrated Care Northamptonshire, said: “Ensuring digital ReSPECT is accessible and available across Northamptonshire supports both patients and professionals.

“The ReSPECT process creates a personalised recommendation to guide appropriate care and treatment in an emergency situation, where someone is no longer able to make decisions or express their wishes. We are working hard to share information that will enhance joined up care.”

The digital ReSPECT form, which was accredited for use in December 2022, is also compatible with NHS England’s National Record Locator, enabling emergency care information to be retrieved across geography when needed.