What’s in What’s in ITIT for Clinicians for Clinicians

GOLD STANDARDS GOLD STANDARDS For GOLD PATIENTSFor GOLD PATIENTS

Dr Elizabeth IrelandDr Elizabeth IrelandDr Libby MorrisDr Libby Morris

WHAT’s in WHAT’s in ITIT for for PATIENTS!

GOLD STANDARDS GOLD STANDARDS For GOLD PATIENTSFor GOLD PATIENTS

Dr Elizabeth IrelandDr Elizabeth IrelandDr Libby MorrisDr Libby Morris

Gold Standards FrameworkGold Standards FrameworkScotland 2003-6Scotland 2003-6

To enable all primary To enable all primary care teams to offer care teams to offer any patient nearing any patient nearing the end of life, the the end of life, the same access to high same access to high quality palliative care quality palliative care so they can choose, if so they can choose, if they wish to die at they wish to die at home.home.

‘ ‘Looming epidemic of need for end Looming epidemic of need for end of life care’of life care’

‘‘Why are we leaving it to luck?’Why are we leaving it to luck?’ Joanne Lynn Joanne Lynn

““What will we need when we are dyingWhat will we need when we are dying??We need reliability, We need a care system we can We need reliability, We need a care system we can count on- Doing RIGHT thing at RIGHT timecount on- Doing RIGHT thing at RIGHT time

To make excellent care routine we must learn to do To make excellent care routine we must learn to do routinely what we already know must be doneroutinely what we already know must be done

All All that it takes is innovation, learning, that it takes is innovation, learning, reorganisation and commitment !”reorganisation and commitment !”

Better Health Better Care

•We are committed to the delivery of high quality palliative careto everyone in Scotland who needs it, on the basis of need not diagnosis,

and according to established principles of equity and personal dignity.•Extend the use of high quality

generalist palliative care standards in all care settings

LIVING and DYING WELLLIVING and DYING WELL

National Action PlanNational Action Plan

Palliative and End of Life CarePalliative and End of Life Care

LIVING and DYING WELLLIVING and DYING WELL

LIVING and DYING WELLLIVING and DYING WELL

•Assessment and Review of palliative and end of life care needs

•Planning and delivery of care for patients with palliative and end of life care needs

•Communication and Coordination

•Education, training and workforce development

•Implementation and future developments

Direct Enhanced ServiceDirect Enhanced Service

QIS Key Performance Indicators for Out QIS Key Performance Indicators for Out of Hoursof Hours

Communication and CoordinationCommunication and Coordination

ACTION 16ACTION 16

NHS Boards should ensure that safe and NHS Boards should ensure that safe and effective processes, electronic or otherwise, are effective processes, electronic or otherwise, are in place 24/7, to all relevant profressionals and in place 24/7, to all relevant profressionals and across sectoral organisational boundaries of across sectoral organisational boundaries of patient information as identified in the electonic patient information as identified in the electonic palliative care summary ( ePCS) regarding any palliative care summary ( ePCS) regarding any patient identified with palliative care needs and patient identified with palliative care needs and who gives consentwho gives consent

ACTION 17ACTION 17The Scottish Government will appoint a clinical The Scottish Government will appoint a clinical

lead to take forward the national roll out of the lead to take forward the national roll out of the ePCS in 2009ePCS in 2009

ACTION 18ACTION 18The National eHealth Clinical lead will establish The National eHealth Clinical lead will establish

a Palliative care eHealth advisory group to a Palliative care eHealth advisory group to explore mechanisms to encourage and explore mechanisms to encourage and maximise the use of the ePCS and to identify maximise the use of the ePCS and to identify further opportunities created by technology further opportunities created by technology and telemedicine to support and enhance and telemedicine to support and enhance palliative and end of life care.palliative and end of life care.

Palliative Care SummaryPalliative Care Summary

DunblaneDunblane

44thth Nov 2008 Nov 2008

System Overview

OOH clinician ECS summary

request & display

ECS update

1. During consultation

2. Due to prescription

3. Other Patient contact

Who saw who for practice?

ECSSyste

m

NHS 24

A&E

Ambulance

TBD…

Practice Admin. Staff

PracticeServer

GP consultation

PRACTICE

Palliative Care SummaryPalliative Care Summary

Macmillan Nurses led initiativeMacmillan Nurses led initiative

Palliative Care FormsPalliative Care Forms– Based on Gold Standards Framework Based on Gold Standards Framework

Scotland (GSFS)Scotland (GSFS)– Paper process already in place in Paper process already in place in

many GP Practicesmany GP Practices– IT Development to assist with key IT Development to assist with key

patient grouppatient group

GSFS SolutionGSFS Solution

Extension to ECS dataset to include more Extension to ECS dataset to include more detailed information to send to OOH for detailed information to send to OOH for Palliative Care patients (known as PCS)Palliative Care patients (known as PCS)Move from paper to electronic informationMove from paper to electronic informationReduction in faxes from GP Practices to OOH Reduction in faxes from GP Practices to OOH CentresCentres

Consent ModelConsent ModelECS – Implied to send, Explicit to viewECS – Implied to send, Explicit to viewPCS – Explicit to send, Implied to viewPCS – Explicit to send, Implied to view

Palliative Care OOH Palliative Care OOH SummarySummary

Palliative Care DatasetPalliative Care DatasetCaptured within GP system – some already Captured within GP system – some already pre-populated:pre-populated:

– Palliative care register flag (Read code) consentPalliative care register flag (Read code) consent

– Carer details and key professionalsCarer details and key professionals

– Diagnosis and current treatmentDiagnosis and current treatment

– Preferred place of carePreferred place of care

– Current care arrangementsCurrent care arrangements

– Patients and Carers Awareness of ConditionsPatients and Carers Awareness of Conditions– Advice for OOH careAdvice for OOH care

SummarySummary

ECS connected to 99% of practicesECS connected to 99% of practices

Accessed by A/E, NHS24 and OOHsAccessed by A/E, NHS24 and OOHs

Palliative Care Summary next Palliative Care Summary next developmentdevelopment

Pilots in Grampian for EMIS and INPSPilots in Grampian for EMIS and INPS

Next year for GPASS and ASCRIBENext year for GPASS and ASCRIBE