stephen burrows, north west epaccs project lead, greater manchester, lancashire and south cumbria...
TRANSCRIPT
Lessons learned in EPaCCS
implementation!
Stephen Burrows
North West EPaCCS LeadGreater Manchester, Lancashire and South Cumbria
and Cheshire & Merseyside Strategic Clinical Networks
23rd February 2016
What is an EPaCCS?
List or Register
End of life care tool
The Bible!
What is an EPaCCS?
• records and shares people’s preferences and wishes about their end of life care, with everyone involved in their care
• improves co-ordination of care by making information available in real-time 24 hours a day
• supports appropriate treatment decisions and interventions
• allows more people to die in the place of their choice
What is an EPaCCS?
• electronic sharing of people’s preferences and wishes about their end of life care
What is an EPaCCS?
What is an EPaCCS implementation?
Operational status
• Partial – some sharing is taking place
• Full – sharing is across all EoLC services
Potential stakeholders:
• GPs
• Out of hours GP service
• District nursing service
• Specialist palliative care - community services
• Care homes
• Acute hospital services
• A&E
• Ambulance service
• Hospice
• Social care
• Tertiary services
• Mental health services
• Prisons
What is an EPaCCS implementation?
Operational status
• Partial – some sharing is taking place
• Full – sharing is across all EoLC services
Geographical scope
• Partial – pilot involving small group of services
• Full – services are engaged across whole locality
What is an EPaCCS implementation?
Operational status
• Partial – some sharing is taking place
• Full – sharing is across all EoLC services
Geographical scope
• Partial – pilot involving small group of services
• Full – services are engaged across a locality
Service engagement
• Partial – some clinicians / care workers / teams using EPaCCS
• Full – all clinicians / care workers teams using EPaCCS
What is an EPaCCS implementation?
SALFORD IMPLEMENTATION
Operational status
• Partial – sharing is taking place between GPs, acute trust, community teams, hospice, social care, OOH and NWAS.
Geographical scope
• Full – above services are engaged across the whole locality, with 61% of expected deaths for Salford having an EPaCCS record (in 2014).
Service engagement
• Partial – issues with not all GPs using EPaCCS; EPaCCS only rolled out to a handful of teams within acute trust etc.
Real time sharing
• Partial – sharing from GPs to acute, community, hospice and social care on a daily basis, sharing by other services in real time; issues with GP updating of records.
“The only source of knowledge is experience”
Albert Einstein
Lessons learned
Lessons learned
Lessons learned
• Reference site visits
• Risks & issues logs
• Business case
• Implementation plan
• Local / regional / national reference groups
• Identification of 20 EPaCCS ‘localities’ across the North West (33 CCGs), and subsequent setting up of EPaCCS Task Groups to meet regularly and represent the range of stakeholders within a locality involved in End of Life Care (EoLC).
• Regional support and networking provided through the creation of EPaCCS Network Implementation Groups (NIG) – for Cheshire & Merseyside, Greater Manchester, and Lancashire & Cumbria – that meet quarterly, and share best practice / developments via a Yammer network.
The North West EPaCCS
Thinking big #1
What is being shared?
• Is all EoLC communication covered within the dataset, or are there still items being faxed?
• Does the scope need to be widened to include other elements of EoLC (kidney care, children’s EoLC etc.) or does the dataset expand to become a supportive care or other wider dataset?
Thinking big #2
Who is it being shared with?
• Which roles have the responsibility to create, read or write to an EPaCCS record?
• Is all EoLC communication only to take place between services within your locality?
• Which services outside of your locality are fundamental to a person’s end of life care?
Ambulance service
Tertiary services
Acute trusts, hospices
GPs, community
Thinking big #3
How is it being shared?
• Is there a single system, or a multitude of systems in use across EoLC services?
• Are there any existing forms of interoperability or electronic communication already taking place?
• Are there any IM&T projects that are larger than EoLC that an EPaCCS can sit within, such as an integrated care record?
• What additional interoperability are your system suppliers working on, or even providing in other areas?
Thinking big #4
Who knows about it?
• Someone, somewhere, in another meeting will be talking about it …
• Who is ‘on board’ with your implementation?
• Integrated Care Boards?
• Strategic Clinical Networks?
• Devolved regional organisations?
• Academic Health & Science Networks?
• CLAHRCs? (Collaboration for Leadership in Applied Health
Research and Care)
When will this all happen?“From March 2018 all individuals will be enabled to view
their care records and to record their own comments and preferences on their record, with access through multiple routes …”
Local digital roadmaps detailing steps to ensure“all electronic health records will be fully interoperable so
that patient records are paperless” –i.e. 100% rollout of Electronic Palliative Care Coordination
Systems (EPaCCS) across England by 2020
(Five Year Forward View / Personalised Health and Care 2020 )
Thinking big #5
• Use existing systems
• Avoid / reduce duplication of existing EoLC
recording
• Replace / reduce other non-electronic EoLC
communication
• Quick and easy to use, avoiding over use of
text
• Ensure sustainability and make ‘future-proof’
North West approach
Continued challenges in progressing EPaCCS
• Leadership
• Clinical engagement
• IT engagement
• Finance
