1. Whats in IT for Clinicians GOLD STANDARDS For GOLD PATIENTS Dr Elizabeth Ireland Dr Libby Morris

2. WHATs in IT for WHATs in IT for PATIENTS! GOLD STANDARDS For GOLD PATIENTS Dr Elizabeth Ireland Dr Libby Morris

4. Gold Standards Framework Scotland 2003-6 To enable all primary care teams to offer any patient nearing the end of life, the same access to high quality palliative care so they can choose, if they wish to die at home. To enable all primary care teams to offer any patient nearing the end of life, the same access to high quality palliative care so they can choose, if they wish to die at home.

5. Looming epidemic of need for end of life care Looming epidemic of need for end of life care

6. Why are we leaving it to luck? Joanne Lynn What will we need when we are dying?What will we need when we are dying? We need reliability, We need a care system we can count on- Doing RIGHT thing at RIGHT time To make excellent care routine we must learn to do routinely what we already know must be done All that it takes is innovation, learning, reorganisation and commitment !

7. Better Health Better Care We are committed to the delivery of high quality palliative care to 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

9. LIVING and DYING WELL National Action Plan Palliative and End of Life Care

10. LIVING and DYING WELL

11. 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

12. Direct Enhanced Service QIS Key Performance Indicators for Out of Hours

13. Communication and Coordination ACTION 16 NHS Boards should ensure that safe and effective processes, electronic or otherwise, are in place 24/7, to all relevant profressionals and across sectoral organisational boundaries of patient information as identified in the electonic palliative care summary ( ePCS) regarding any patient identified with palliative care needs and who gives consent

14. ACTION 17 The Scottish Government will appoint a clinical lead to take forward the national roll out of the ePCS in 2009 ACTION 18 The National eHealth Clinical lead will establish a Palliative care eHealth advisory group to explore mechanisms to encourage and maximise the use of the ePCS and to identify further opportunities created by technology and telemedicine to support and enhance palliative and end of life care.

16. Palliative Care Summary Dunblane 4 th Nov 2008

17. 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? ECS System NHS 24 A&E Ambulance TBD… Practice Admin. Staff GP consultation PRACTICE

18. Palliative Care Summary Macmillan Nurses led initiative Palliative Care Forms –Based on Gold Standards Framework Scotland (GSFS) –Paper process already in place in many GP Practices –IT Development to assist with key patient group

19. GSFS Solution Extension to ECS dataset to include more detailed information to send to OOH for Palliative Care patients (known as PCS) Move from paper to electronic information Reduction in faxes from GP Practices to OOH Centres Consent Model ECS – Implied to send, Explicit to view PCS – Explicit to send, Implied to view

20. Palliative Care OOH Summary

21. Palliative Care Dataset Captured within GP system – some already pre-populated: –Palliative care register flag (Read code) consent –Carer details and key professionals –Diagnosis and current treatment –Preferred place of care –Current care arrangements –Patients and Carers Awareness of Conditions –Advice for OOH care

22. Summary ECS connected to 99% of practices Accessed by A/E, NHS24 and OOHs Palliative Care Summary next development Pilots in Grampian for EMIS and INPS Next year for GPASS and ASCRIBE