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ePCS electronic Palliative Care Summary

ePCS electronic Palliative Care Summary. http://www.palliativecareggc.org.uk/ Euan Paterson Macmillan GP Facilitator (GG). Questions?. Who is using it already? What is it for?!? What does it contain? How does one use ePCS? Where is it? Which patients? What are the problems?

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ePCS electronic Palliative Care Summary

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  1. ePCSelectronic Palliative Care Summary http://www.palliativecareggc.org.uk/ Euan Paterson Macmillan GP Facilitator (GG)

  2. Questions? • Who is using it already? • What is it for?!? • What does it contain? • How does one use ePCS? • Where is it? • Which patients? • What are the problems? • What are the benefits? • How does it fit with the Palliative Care DES?

  3. ePCS – what it is for • Information transfer – unscheduled care • ‘In hours’ GP > OOH • Primary Care > A&E / Acute Receiving Units • Primary Care > Scottish Ambulance Service • Primary Care > Specialist Palliative Care Centres • Prompts for proactive care • Anticipatory Care Planning • All data stored in one place • e-referral to Specialist Palliative Care • Structure for lists / meetings / etc • Palliative care DES

  4. ePCS - contents • Information upload • Palliative Care review date • Consent to share information

  5. ePCS - contents • Current situation • Diagnoses • Key personnel involved • Carer details • Current treatment • Repeat • Last 30 days Acute • Patient & carer understanding • Diagnosis & Prognosis

  6. ePCS - contents • Future Care Plan • Patient wishes (VISION) • Preferred Place of Care • Resuscitation status • Additional drugs in house (Just in Case) • Advice for OOH GP e.g. • Contact own GP OOH • GP willingness to sign death certificate • Additional OOH information (KEY section) e.g. • Patient wishes • Starting Liverpool Care Pathway • Etc…

  7. ePCS – how to use it • Data entry • Find the template!

  8. ePCS – how to use it • Data entry • Find the template! • Decide who should have one

  9. ePCS – who should have one • Patients with supportive / palliative care needs • Whoever YOU feel should be included! • Palliative care register • GSF register • SPICT / GSFS prognostication guidance?

  10. ePCS – who should have one • Patients with supportive / palliative care needs • Whoever YOU feel should be included! • Palliative care register • GSF register • SPICT / GSFS prognostication guidance? • Chronic disease registers? • Care Home patients? • Housebound patients? • Perhaps need to ‘stratify’? • Supportive and Palliative Action Register (SPAR)?

  11. ePCS – how to use it • Data entry • Decide who should have one • Add initial data via ePCS template (EMIS) / via ePCS guideline (INPS • Then • Obtain consent • Add palliative care review date • THEN • Add to Palliative Care register • Add / update ePCS fields as clinically indicated

  12. ePCS – concerns • Data entry • Possible duplication • Visiting – particularly ‘on the way home’ • OOH data entry • Data entry by AN Other… • Different systems • INPS / ePCS approach it quite differently! • The GPASS migration...

  13. ePCS – concerns • Data transfer • Remembering to obtain consent • Delay in data transfer • Data access • OOH DNs do not have access to information • Contract • Same codes used by ePCS and PC DES

  14. ePCS – patient & carer benefits • Targets a very vulnerable and needy group • Encourages earlier identification • Encourages anticipatory care planning • All professionals have better information • Fewer inappropriate actions • Transfer • Admission • Futile attempt at CPR • Reassurance and ‘security’ • Better and safer care

  15. ePCS – General Practice benefits • In hours • Natural extension of GSFS • Simple information transfer • More effective • Less work • Fits in with palliative care DES • Out of hours • Information – more / legible / no transcription • Less patient contacts(?)

  16. ePCS – NHS benefits • Better service • Information transfer • Increased pro-activity • Fewer inappropriate actions • Admissions • 999 ambulances • Futile CPR • Decreased OOH contacts • Save money

  17. Palliative Care DES (2012-13) • Decide who should be on it (as for ePCS) • Add data via ePCS template (EMIS) / via ePCS guideline (INPS) • Relevant diagnoses • Then • Obtain consent • Add palliative care review date • THEN • Add to Palliative Care Register • Payment • £56/patient • No cap

  18. Palliative Care DES (2012-13) • Level 2 • Significant Event Analysis • 1 per 1000/list • Malignant / non-malignant • Not on PC register • No ePCS • No DNACPR • Preferred place of care / death – met / not met • LCP used / not used • Payment • £250 administration • £23/SEA (max 1/1000/list)

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