Alongside the day to day work of the CMC service there are a number of additional areas that we are developing where we recognise CMC could play an important role. These are outlined below, and we would be pleased to hear from colleagues who want to find out more, or get involved.
One of our biggest pieces of work going forward is supporting patients in starting their own urgent care planning and being in the driving seat of the process while still working alongside their healthcare professional teams. Patients having ‘read only’ access to their existing urgent care plans is one such effort, but the vision is to ultimately have a patient portal where patients can start to create their own urgent care plans and document their preferences and wishes by virtue of a guided questionnaire which will also include relevant information, videos and guidance geared to the patient perspective.
Children and Young People
The current CMC system has been developed to be suitable for use with children and young adults, and the appropriate governance issues have been addressed. We are committed to ongoing work to further develop the system to reflect the needs of children and young people so if any of our colleagues currently working in paediatric/children’s services would like to get in touch and help us develop this work further we would be very receptive. We would also like to hear from a healthcare professional working with children who would be interested in joining the CMC External Governance Board.
CMC and Acute Hospitals
There is a growing interest in CMC from acute hospitals particularly A&E departments. This includes both the creation and viewing of urgent care plans. We have undertaken work in some hospitals to ensure CMC plans are automatically flagged to those working in acute settings. We recognise that hospitals are complex organisations and that we need to work with clinicians across a range of specialities, as well as I.T. departments and general management to drive uptake of CMC and help improve communication between services.
London Ambulance Service
We enjoy a close collaboration with the London Ambulance Service (LAS) and have seen an increasing number of emergency services, urgent care services and OOHs professionals viewing urgent care plans. We continue to work with the organisation to deliver bespoke training materials for the Clinical Hub and looking at ways to further integrate our work.
Thinking beyond EOLC
We are increasingly seeing the important application of CMC beyond the end of life/palliative care beginnings from which we started. We think that CMC could play an important role for other patient cohorts, such as those with long-term medical conditions where an urgent care situation could arise more frequently and in specific areas such as dementia or chronic respiratory disease. We would love to hear from you across the MDT and clinical spectrum to see how CMC might benefit your patients.
We have established a Patient Reference Group to ensure our service and materials benefit from the patient and carer perspective and are always looking for new members to this group to increase the diversity and experiences available to us. We also hold a quarterly Clinical Forum to ensure the needs of clinicians using CMC are being met, and work with the group to test ongoing content and learn more about the commissioning and policy environment they are operating in.
We also hold a regular stakeholder meeting where anyone associated with CMC, from CCG commissioners to GPs to administrators are welcome to attend and get updates on the service as well as give feedback on ongoing refinements. This type of engagement and the feedback we receive is highly informative to our work and to ensure CMC is as relevant and as useful as possible.
We work in collaboration with a number of institutions including Imperial College London to further research and education around advance/urgent care planning. We are a partner in a major research project to assess the effectiveness of advance care plans for homeless people and are working closely with NHS England and the Healthy London Partnership to promote the London Digital Programme and what connected information sharing will look like in the future.