Manchester Care Record adds end-of-life plans

Manchester is incorporating ‘end-of-life’ care plans into its shared records scheme.

The Manchester Care Record project, which uses Graphnet's CareCentric software, is also testing a new data feed from Manchester Mental Health and Social Care Trust.

The new Electronic Palliative Care and Coordination System has been co-designed by local GPs and clinicians and is being trialled by a small number of practices, with plans for a full roll-out from next month.

GPs can create and input the end-of-life plans directly into CareCentric, which can be accessed via a button embedded within their Emis Web clinical system.

Manchester Care Record senior project manager Martin Jones told Digital Health News: “Following initial findings that are proving benefits to both patients and staff, we are looking to grow to incorporate all 90 GP practices going live with EPaCCs within the next 12 months.”

Central Manchester, North Manchester and South Manchester clinical commissioning groups worked with Manchester City Council to go live with the shared record scheme last summer.

It pulls information from various IT systems into a single record for patients “at risk” of presenting for unscheduled care.

Jones explained that there is a set of documents that capture a patient’ wishes and key information in the last years of life, such as do not resuscitate orders. The new EPaCCS system will point users to where these documents can be found so staff, such as those working in A&E and the ambulance service, can be aware of them before they start treatment.

Access for ambulance staff has not yet gone live as they first need the technology in place, such as an N3 connection. Initially, it will be call handling teams, which include clinicians, who will access the plans and relay information to paramedics on the ground.

Longer term aims include extending access to the city’s main hospice and to NHS 111 staff. Jones said another new feature of the shared record scheme is a feed from Manchester Mental Health and Social Care Trust.

This includes mental health appointments. any risks or clinical action plans and known issues such as aggressive behaviour or medications to avoid. The pilot feed has proved very successful and the plan is to go fully live in the next month.

Data is already available from 90 GP practices, Manchester City Council’s social services department, Central Manchester University Hospitals NHS Foundation Trust, Pennine Acute Hospitals NHS Trust and University Hospitals of South Manchester Foundation Trust.

While the system was created to cater for the ‘high risk’ patients, Jones said that once benefits for these patients are clearly identified the plan is to use the same infrastructure and sharing agreements to create records for all Manchester patients.

It is the GP's role to explain the shared care scheme to patients and ensure they consent. Users are also encouraged to ask for explicit consent from patients to view a record.