Information Standards for End of Life Care
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Transcript of Information Standards for End of Life Care
WELCOME
Friday 17 April 2015 WebinarInformation Standards for End of Life Care
(ISB150) supporting the implementation of Electronic Palliative Care Coordination
systems (EPaCCs)
Information Standards for End of Life Care (ISB150) supporting the implementation of Electronic Palliative
Care Coordination systems (EPaCCs)
Friday 17 April 2015
12.30pm – 1.30pm
Chris Wike & Adam HatherlyNHSIQ & Health & Social Care Information Centre
&
Beverley MatthewsLTC Programme Lead, NHS Improving Quality
Bev MatthewsA nurse by background, Beverley has worked extensively throughout the NHS in a variety of clinical, managerial and strategic roles. Beverley’s current role as Programme Delivery Lead for Long Term Conditions Improvement Programmes: LTC Year of Care Commissioning Model and LTC Framework. Prior to joining NHS Improving Quality in April 2013, Beverley was Director of NHS Kidney Care and NHS Liver Care.
Passionate about service transformation through developing networks and leading complex programmes. Providing strategic leadership to partners within health communities, managing stakeholders and working across agencies.
Adam Hatherly, Senior Solution Architect, Health & Social Care Information Centre
Working to support care coordination for long term conditions and end of life care, focusing on developing national resources to support local delivery of solutions. Adam is closely involved in the development of national interoperability strategy and standards.
Christine Wike, NHSIQ Delivery Support Manager for End of Life care
Supporting the roll out of NHS IQs 2 national programmes : The Transforming Care in Acute Hospitals and Electronic Palliative Care Coordination Systems (EPaCCS) . Working in partnership with the National End of Life Care Intelligence Network in Public Health England in the development and maintenance of the National Information Standard (ISB150) for End of Life Care that supports Electronic Palliative Care Co-ordination Systems (EPaCCS).
Meet the Speakers
Beverley Matthews
LTC Programme LeadNHS Improving Quality
LTC Year of Care Commissioning Programme:
• 5 Early Implementer sites
• 35 Fast Followers
• Whole Population Datasets
• Implementation Guide
• Simulation Modelling
• Specialist Support Team
LTC Person Centred CareImprovement Programme:
• 40 Early Implementer sites
• 4 regional learning networks
• Snapshot Survey
• Simulation Modelling
• Specialist Support Team
Long Term Conditions Learning Community
• LTC Dashboard
• Case Studies
• Lunch and Learn Series
• The Bulletin
• Specialist Support Team
@NHSIQ @bev_j_matthews #LTCimprovement #LTCyearofcare
LTC Lunch & Learn Series ….coming soon…
Date Webinar Hosted by Bev Matthews &
29 April 201512:00 – 13:00
Information Sharing for Care Coordination Adam Hatherly, HSCIC&
Christine Wike, NHSIQ
1 May 201512:30 – 13:30
Information as a Therapy Mark DumanMRPharmS DirectorMonmouth Partners
6 May 201512:30 – 13:30
Prevention & Effective Interventions inFrailty
Helen LyndonNurse Consultant Older People, Clinical
Lead Frailty, NHS England
27 May 201512:30 – 13:30
Primary Care Workforce for the 21 Century Webinar
Sharon LeePrimary Care Workforce Facilitator
South Kent Coast CCG
9 June 201512 noon – 1pm
Health 1000 Rob MeakerBarking, Havering & Redbridge
To pre-register email [email protected]
2014 Position
Chris Wike Delivery Support Manage EoLC NHS IQ
Information Standard for End of Life Care (ISB150);Supporting implementation of Electronic Palliative care Coordination Systems -EPaCCS
Agenda
Learning Outcomes
• Understand its purpose including the requirements , structures and definitions for the standard
• Identify the core content to be held in an EPaCCS system
• Understand how the standard supports care coordination and supports choice in End of Life care
Purpose
• The End of Life Care Co-ordination (EoLCC) National Information Standard (ISB 1580) aims to improve the co-ordination of care through better communication of people’s wishes and preferences for care at the end of life.
• The standard specifies the core content to be held in Electronic Palliative Care Co-ordination Systems (EPaCCS), or paper-based care co-ordination systems.
• Evidence is emerging that the standard improves care co-ordination, supporting more people to die in their place of choice (What we know now 2013, PHE National End of Life Care Intelligence Network).
• When a person is approaching the end of life, all professionals involved in their care should have secure access to complete and up-to-date information regarding their expressed preferences.
It is a case of the right person, having the right information, at the right time, which can make all the difference to the quality and experience of care for an individual, their family and carers.
Background
– EPaCCS support communication of people’s preferences and choices regarding end of life care with professionals delivering care.
– ISB1580 identifies the core content held in EPaCCS
– Standard was approved in March 2012 / Amends Dec 2013
– Joint SROs: NHSE and PHE
13ISB1580: Change Proposal Feb 2015
Summary Core Data Items1 Consent
Consent Status*2 Record creation* date AND record amendment* dates3 Plan and requested actions
Planned review dateCardiopulmonary Decision – whether a decision has been made, the decision, date of decision, location of the documentation and date for reviewPreferred Priorities for Care
4 Person DemographicsPerson Name* including preferred nameDate of birth*Person address*NHS Number*Person telephone numberGenderRelevant contactsMain carer name and contact detailsAvailability of carer support*
5 Special requirementsNeed for interpreterPreferred spoken languageFunctional status and disabilityEnd of Life Care Tools in use eg Gold Standards Framework
6 Information and advice givenIs main carer aware of person’s prognosis?Family member/carer informed of cardiopulmonary resuscitation clinical decision
7 GP PracticeGP Name*GP Practice details*
8 Key workerNameTelephone number
9 Services and care Names of health and social care staff and professionals involved in careProfessional groupTelephone number
10 DiagnosesPrimary end of life care diagnosis*Other relevant end of life care diagnoses and clinical issuesLikely prognosis
11 Allergies or adverse reactions
12 Medications and medical devicesWhether a ‘just in case box’ or anticipatory medicines have been prescribedWhere these medicines are kept
13 Legal informationAdvance statementRequests or preferences that have been statedAdvance Decision to Refuse Treatment (ADRT)Whether a decision has been made, the decision, date of decision and the location of the documentationLasting Power of Attorney or similarName and contact details of person appointed with Lasting Power of Attorney (LPA) for personal welfare• without authority to make life-sustaining decisions• with authority to make life-sustaining decisions
14 Person and carers’ concerns, expectations and wishesPreferred place of death 1st and 2nd choices if madeNames and contact details of others (1 and 2) that the person wants to be involved in decisions about their careOther relevant issues or preferences around provision of care?
15 Actual place of death
16 Date of death
* Indicates mandatory items
2015 ISB Proposed Changes- overview
Responding to issues raised by implementers, IDSMG, CPAGLCP phased out July 2014 and Judicial Review Ruling: DNACPRIncluded:• Minor editorial• New data item: last days/weeks of life• Data Set Amendments:• - Carer terminology• - DNACPR• - Preferred & actual place of death• - Summary table• - NHS number- status• - ICP removal term• - Title of the standard• Amendments to Guidance Documents• Aligns with standards for the clinical structure and content of patient
records published by Academy of Medical Royal Colleges (AoMRC).
17ISB1580: Change Proposal Feb 2015
The guidance has been endorsed by:
Association for Palliative MedicineAssociation of Directors for Adult Social ServicesRoyal College of NursingRoyal College of GPsRoyal College of PhysiciansCollege of ParamedicsCollege of Emergency MedicineCollege of Occupational TherapistsChartered Society for PhysiotherapyBritish Geriatrics Society
http://www.endoflifecare-intelligence.org.uk/resources/publications/implementation_guidancehttp://www.endoflifecare-intelligence.org.uk/resources/publications/record_keeping_guidance
EPaCCS -
By 2015 there will be 70% rollout of EPaCCS across England (baseline 15%)
Levels of ambition
Spread and adoption
Update: national information standard & EPaCCS survey20
2009
fullpartialplanned
implementation
Pilot sites
2012
EPaCCS Implementation 2013
Update: national information standard & EPaCCS survey 21
Operational
Planning started
Planning not started
Not known
PHE Centre boundary
Operational defined as; when there is an electronic system linking care providers across a locality
CCGs
IT systems being used (operational & planned)
Update: national information standard & EPaCCS survey 22
2014 /15 Our assumption on current position
Has a "IT system"conforms with EPaCCs(partial to full)with plans: from earlyto well developed plans
No Plans
unknown
43%
25%
31%
1%
Supporting Wider Implementation –& next steps
• Maintenance of ISB Standard for End of Life Care –Progressing with change application - submit to SCII June 2015
• Lessons learnt published August 2014
• Providing ongoing support for implementation sites
• Regional Events - SCNs
• Plans to commission an evaluation 2015/16
Typical EPaCCS Technical Approaches
Shared Clinical System: Dedicated Care Planning System:
SCR as an EPaCCS: Clinical Portals:
• Common Technical Challenges: • Interoperability (Double-entry, Keeping records in-sync)• Consent (System-specific sharing models)• Reporting
Further Information ;
http://www.endoflifecare-intelligence.org.uk/national_information_standard /
http://www.nhsiq.nhs.uk/improvement-programmes/long-term-conditions-and-integrated-care/end-of-life-care/coordination-of-care.aspx
http://coordinatemycare.co.uk /