More than 100,000 people now have a digital ReSPECT form or end of life care plan in place following a large-scale rollout across five Integrated Care Systems (ICSs) using the NHS’s CIPHA platform.
This milestone marks a significant step forward in delivering personalised emergency care plans at scale. Each year, around 550,000 people die in England, with approximately 42 per cent dying in hospital. Evidence suggests that system-wide use of digital care plans will allow tens of thousands of patients to die at home if they want to, both improving care and freeing up hospital beds.
The solution pulls in clinical data from across the shared care record and allows clinicians and patients to add personalised recommendations for emergency care and treatment – including decisions around CPR. Because the digital version is embedded directly into the shared care record, these preferences are accessible in real time across the health and care system. This means, for example, that ambulance dispatchers, paramedics, or emergency department clinicians can quickly access a patient’s wishes and clinical recommendations, helping to ensure that care is delivered in line with what matters most to the individual.
The Nuffield Trust has estimated the cost of caring for patients in their last year of life at £22 billion annually. Evidence shows that this initiative will have a major impact on hospital activity as well as being extremely supportive of patients and relatives at a very stressful period.
The digital ReSPECT form is fully compatible with NHS England’s National Record Locator (NRL), enabling emergency care information to be retrieved across geography when needed.
This national interoperability means key emergency care documentation can be accessed wherever a person presents, supporting fast, informed and personalised clinical decision-making.
The CIPHA system, which is supplied by Graphnet Health, is a combined population health, single patient record, workflow/pathway, analytics and remote monitoring system used by 11 ICSs covering 17m patients. The ReSPECT and end of life systems are currently used by Bath, North East Somerset, Swindon and Wiltshire (BSW), Kent, Northamptonshire, Staffordshire and Greater Manchester. Subject to further funding, the programme will be extended across the wider CIPHA user base, supporting accessible end-of-life plans for over 300,000 people.
“Ensuring digital ReSPECT is accessible and available across Northamptonshire supports both patients and professionals. The ReSPECT process creates a personalised recommendation to guide appropriate care and treatment in an emergency situation, where someone is no longer able to make decisions or express their wishes. We are working hard to share information that will enhance joined up care.”
– Claire Mansfield, Macmillan Palliative and End of Life Care Transformational Leader at Integrated Care Northamptonshire:
“Having that information available digitally, via the shared care record, to everyone involved in an individual’s care means no time is wasted in the event of an emergency.
“Whether it’s a paramedic attending to a patient or a doctor in an emergency department, they provide clarity around what the patient’s wishes are and what the clinical recommendation is for certain treatments and procedures”.
– Dr Zia Din, joint chief clinical information officer and ReSPECT lead for the Staffordshire and Stoke-on-Trent Integrated Care System (ICS)
“The NHS has been wrestling with the deployment of digitized end of life plans for decades and I am delighted that we are finally able to roll out a solution at scale. It is CIPHA’s combination of shared care record, analytics, population health, workflow and forms along with the widespread use of the system which have made this possible.
“Population health is at the forefront of the drive towards more personalized, joined up and compassionate care and I look forward to a time when anyone that needs an end-of-life plan has one.” – Markus Bolton, Director, Graphnet Health
