I thought forum members might be interested in reading about a scheme that is being rolled out in London at the moment, that if successful may become available country wide, it sounds like a real step forward in giving patients agency in regards to their end of life choices and treatment decisions.
Londoners are being urged to complete an online care plan that outlines how and where they should be treated by the nhs if they become seriously ill.
It enables them to choose to die at home rather than in hospital and can prevent paramedics from attempting potentially futile resuscitation if they suffer cardiac arrest.
The doctor leading the roll-out of the scheme said it could prevent people with terminal illnesses turning to foreign clinics such as Dignitas as they knew their death would be handled as they wished by the NHS.
Health Secretary Matt Hancock described the scheme, Co-ordinate My Care (CMC), which is being pioneered in the capital, as “brilliant”. He said it would help avoid “unnecessary and distressing” trips to A&E.
More than 81,000 Londoners with long-term health conditions already have a CMC care plan, including young adults with chronic conditions such as cystic fibrosis and sickle cell disease and elderly people with dementia.
It means that medics have an instant reference point as to that patient’s health, previous treatment and their wishes for end-of-life care.
But CMC schemes are about more than end-of-life planning - they also benefit patients who have a chronic illness and may need the support of urgent care services such as 111, 999 or the out of hours GPs.
Since May, the scheme has been open to all adult Londoners, enabling them to go online to fill in their own plan, known as myCMC.
It is sent electronically to their GP and formally approved - and entered onto the NHS database - after the patient has met their doctor or nurse to discuss their choices.
Professor Julia Riley, a palliative care specialist at the Royal Marsden Hospital, championed the idea of ensuring patients had a “better death” after being distressed at the way her sister-in-law Helena died from cancer aged 32 almost 20 years ago.
She said myCMC would improve patient care and help to “unblock” A&E departments. More than half of Londoners die in hospital but this falls to 20 per cent for those with a CMC plan.
Profesor Riley said: “People plan their funerals but they don’t plan their death. This helps people to die a better way.
“It’s an entirely different way of looking after vulnerable people, or people who need urgent care services often. It’s just like writing a will - a health and social care will.”
Paramedics know from the minute a 999 call is received whether the patient has a care plan. The plan can be viewed by the patient on their iPhone and updated as often as they wish.
Professor Riley added: “I think if somebody has a plan and knows it will be honoured and respected at a time of need, there is no need to go to a place like Dignitas.”
The scheme has the support of Bowel Babe cancer blogger Deborah James, who is part of the You, Me and the Big C podcast team.
She said: “As someone living with stage four bowel cancer, I should and I must consider how I might want to spend the last days of my life.
“My care plan allows me to outline those wishes. It’s such a tough decision to make but, once made. it’s vital to share this information in emergency situations so that everyone knows what the best thing to do for the patient is.”
Health Secretary Matt Hancock said Coordinate My Care ensured all parts of the NHS knew about a patient’s care.
He said: “It shows the difference the NHS can make to people’s lives when they need it most.
“People with a plan are less likely to die in hospital and can avoid unnecessary and distressing trips to the emergency department.”
Visit mycmc.online
