Frequently Asked Questions

Key Information

The earliest date that the Urgent Care Plan can go live is currently the 1st July 2022. This date is subject to adequate integration with electronic patient records (EPRs) and successful migration of information currently recorded on the existing care planning system to the UCP.

From the 1st April 2022, the care planning service is provided by NHS South West London CCG, the host of the future Urgent Care Plan. The care planning portal, log-ins and in-context links from the previous service provider remain active and supported by the UCP Helpdesk team. Users currently creating and viewing care plans can therefore continue to do so. Organisations that currently receive a data feed to enable manual flagging of care plans will continue to receive this data. There is no gap in the provision of a care planning service until the new Urgent Care Plan is ready to go live.  

The UCP Programme is currently working with multiple vendors to achieve interoperability between the future Urgent Care Plan and Electronic Patient Records in use across London before the Urgent Care Plan goes live.

The care planning system currently in place is the same as the system previously provided by CMC, with a few exceptions:

  • The myCMC patient portal is no longer available as of 1st April 2022. Click here for more information.
  • The care planning application and service responsibility transferred from The Royal Marsden NHS Foundation Trust (RM) to NHS South West London CCG on 1st April 2022.
  • The care planning application and service is no longer called ‘Coordinate My Care’ and CMC branding has been removed.
  • The CMC Helpdesk transferred the same functionalities to the UCP Helpdesk. Details for how to contact the UCP Helpdesk details can be accessed by clicking the ‘Helpdesk’ icon.
  • Clinical and system training for new staff wishing to use the platform is provided by the UCP Programme.
  • The monthly Commissioner Extract Report and other regular data reports will not be available from 1st April 2022 until the UCP goes live.

Existing log-in credentials, access routes and in-context links for accessing the previous system, CMC, remain in place and active. 

Yes! It is important that clinicians continue to plan care with their patients and record these wishes and preferences on the current care planning system.

The information recorded on the existing care planning system supports clinicians, especially ambulance clinicians, to make good clinical decisions. All existing, clinically published care plans will be migrated to and accessible via the Urgent Care Plan from the point of go-live.

Product and Service Information

Extensive stakeholder engagement was conducted between October 2020 and March 2021 to find out what was needed from a care planning solution. Stakeholders identified the following functionalities, which the Urgent Care Plan will provide:

  • Reduced duplication: Care plans can be pre-populated with relevant information from the patient’s GP record from EMIS and TPP SystmOne. This will reduce the need for transcription.
  • Improved accessibility: Users won’t need a separate log-in to access care plans when accessing the solution via a connected Electronic Patient Record systems (EPRs). Care plans will continue to be universally accessible by all clinicians involved in a patient’s care. Urgent Care Services, including the London Ambulance Services, NHS 111 and Out of Hours GP services will be able to access care plans without the need for a separate log-in when accessing care plans via their EPRs.
  • Template development: We will be able to create and edit the care plan templates, making it possible to support a greater variety of clinical pathways, including, but not limited to Urgent Care and End of Life Care.

All existing, clinically published care plans for patients that are alive will be migrated to the Urgent Care Plan. There will be no need to transcribe existing care plans to the Urgent Care Plan. Access to and visibility of care plans will be tested before go-live, to ensure that no data is lost in the migration process.

Draft care plans from the current care planning system will not be migrated to the Urgent Care Plan. In order to ensure that care services are able to make the best use of care plan information from the existing system, clinicians care asked to ensure that all draft care plans are finalised and published (i.e. clinically approved) as soon as possible.

Instructions for how to do this can be found here

Yes, all existing care plan attachments for patients that are alive, will be migrated to the Urgent Care Plan’s digital system, provided by Better. There will be no need to print these in advance. Access to and visibility of care plan attachments will be tested before go-live, to ensure that no data is lost.

Yes, all existing care plan DNACPR information, including attached DNACPR forms, for patients that are alive will be migrated to the Urgent Care Plan. There will be no need to print these in advance, from the existing solution. Users will also be able to print a red border DNACPR from the Urgent Care Plan. Access to and visibility of care plan DNACPR information will be tested before patient care plans are migrated, to ensure that no data is lost.

There is likely to be a short period of time where the care planning system will be unavailable, whilst the migration of care plans to the new system takes place. We will try to ensure that this period takes place outside of core business hours. Current users of the care planning system will be notified in advance of the down-time period.

Patients should speak to their healthcare professional if they would like to see an up to date version of their care plan. A way to enable patients to view or edit their care plans is in development which will enable them to view or edit their care plan in the future. Patients who are interested in being involved in the design, can use our contact form on the Contact Us page. We would love to involve as many patients in this piece of work as possible.

Yes, if your EPR system is integrated with the Urgent Care Plan, patients with a care plan will be flagged. From the go-live of the UCP, this includes EMIS, TPP SystmOne, Cleric ePCR, Adastra (via the Special Patient Notes section) and the London Care Record (Cerner Health Information Exchange). The type of view/edit/create permissions will depend on your role. 

The Urgent Care Plan Programme team are working with Business Intelligence (BI) teams to establish data flows and integrate data from the Urgent Care Plan system into local and regional dashboards. This will enable BI and transformation teams across London to view care planning data in a more holistic way. Further information will be provided in due course.

Until the Urgent Care Plan goes live, activity reports will not be available. This includes the following data reports previously provided:

  • Commissioner Extract Workbook
  • Standard Report
  • Emergency Department viewing
  • Ad-hoc data reports

Implementation

Yes. A desktop client, ‘Valida’, will need to be installed on all computers, including remote devices (i.e. laptops) where EMIS or TPP SystmOne are in use. Once installed, a staff member for each practice (with administration rights to your Electronic Patient Record system) will need to register each user. This will be coordinated by your organisation’s IT team, with support from the UCP Programme. 

Organisations using Adastra will need to upgrade the version of Adastra to v3.39. Only Adastra v3.39 will allow the Urgent Care Plan to be accessible via Adastra. However, the notification of the existence of a care plan in Special Patient Notes is not dependent on an upgrade.

No. Integration with Cleric ePCR is managed centrally by the Urgent Care Plan Programme in partnership with Better and OneLondon. 

No. Integrations with the following Electronic Patient Record systems will be arranged after the Urgent Care Plan goes live: Vision, Cleric CAD, Cerner Millennium, Servelec RIO, System C Medway, Azeuscare, Advanced CareNotes, Allscripts Sunrise, Care First, Corelogic, Epic, iSoft iCM, Liquidlogic, Lorenzo, Servelec Mosaic, Silverlink PAS, SMI iCare. The Urgent Care Plan Programme team will be in touch when arrangements need to be made.

The UCP Programme is working with a group of ‘UCP Champions’, who are invited to attend workshops to develop, refine and test training materials. The UCP Champions workshops are also used to develop and agree training strategies and explore opportunities to deliver training materials in a variety of ways, including via local Learning and Development (L&D) hubs. We anticipate that system training videos and other resources will be available in May. 

Clinical training and clinical engagement will be co-developed, produced and delivered by the UCP Programme, in partnership with London networks, systems and stakeholders. Organisations will need to incorporate clinical training regarding care planning within organisational training programmes. Clinical training is expected to start after the initial implementation phase.

Access

From Go-Live

Users of the following Electronic Patient Record (EPR) systems will have access to care plans via their EPR system without the requirement for logging in twice or entering separate credentials*:

  • EMIS
  • EMIS Community
  • TPP (SystmOne)
  • London Care Record (provided by Cerner Health Information Exchange)
  • Advanced Adastra
  • Cleric ePCR

Users of EMIS and TPP will need to register their CIS (Care Identity Service) Smartcard prior to go-live. Please view the Implementation section above with further information on how this is being coordinated.

Integration with Cleric CAD will be complete once Cleric CAD is implemented across London Ambulance Service in the summer of 2022. Cleric CAD will show that a care plan exists and the care plan and the Urgent Care plan can be launched.

Users of other EPR systems will be able to access the Urgent Care Plan via the London Care Record (Cerner Health Information Exchange) or via a web portal using two-factor authentication from the point of go-live.

Future Roadmap

Access to care plans via the below EPR systems without the requirement for logging in twice or entering separate credentials will be available as part of the digital roadmap. We anticipate these integrations will be available for these EPR systems by April 2023:

  • Vision
  • Cleric CAD
  • Cerner Millennium
  • Servelec RIO
  • System C Medway
  • Azeuscare
  • Advanced CareNotes
  • Allscripts Sunrise
  • Care First
  • Corelogic
  • Epic
  • iSoft iCM
  • Liquidlogic
  • Lorenzo
  • Servelec Mosaic
  • Silverlink PAS
  • SMI iCare.

* This is also known as ‘federated access’ or ‘contextual launch’.

Care plans can be accessed via a web portal. Existing users of the current care planning system will be contacted by the Urgent Care Plan Programme to support them to register. The web portal will be available from the point of go-live.

If your Electronic Patient Record system is integrated with the UCP, your user credentials for accessing your Electronic Patient Record system will be used to authenticate your access automatically. This is the same for users of the London Care Record (Cerner HIE). This will enable users to launch the care plan without having previously registered for an Urgent Care Plan account. 

Access via the Cleric ePCR system will be available, therefore access via the Summary Care Record Application is not necessary.

We anticipate that the same permissions to view/create/edit care plans, known as ‘Role Based Access’, will be used when the Urgent Care Plan goes live. However, a pan-London clinical working group will review this and recommend a policy for Role Based Access. As part of the information sharing agreements, organisations will also be asked to identify a clinical lead to oversee access to, and utilisation of care plans in their organisation.

Contracting and Finance

The future service will continue to be funded by the five London CCGs.

The future contract will be awarded for 3 years (April 2022 to March 2025) with an option for 2 x 12-month extensions.

Background

The way that clinicians shared End of Life and Urgent Care plans across organisations in London, until 31st March 2022, was to document this information on a digital system called Coordinate My Care (CMC). CMC was contracted to deliver this service in London until 31st March 2022. It was therefore a legal requirement to conduct a procurement exercise for a contract for such a service following the expiry of the contract with CMC. The procurement of the Urgent Care Plan follows extensive consultation regarding the digital and clinical support required for a shared care plan application.

The new digital provider underpinning the future Urgent Care Plan is Better. An IT Implementation project, led by the Chief Technology officer for London, has been established to oversee the implementation plan for the digital solution, to ensure that all parties bought into the requirements for the new service.

Better is a leading technology company supporting the NHS with their Digital Health Platform. The Better platform enables fast and agile creation of forms and clinical applications, separated from the data, for instant data access, re-use and expansion. The company’s solutions are putting organisations in control of their data, with the aim of simplifying the work of care teams and accelerating digital development of all data for the lifetime of the person. In the last three decades, Better has provided solutions for more than 150 clients across 16 countries worldwide with their OpenEHR and open standards-based platform and applications.

For information regarding local implementation, you can contact your ICS Lead:

North West London: Michelle Scaife (michelle.scaife@nhs.net)
North Central London: Patrick Schrijnen (patrickschrijnen@nhs.net)
North East London: Toyin Ajidele (t.ajidele@nhs.net)
South East London: Holly Eden (holly.eden@nhs.net)
South West London: Else Krajenbrink (else.krajenbrink@swlondon.nhs.uk) or Viccie Nelson (Viccie.nelson@swlondon.nhs.uk)

Frequently Asked Questions

The current way that clinicians can share End of Life and Urgent Care plans across organisations in London is to document this information on Coordinate My Care (CMC). CMC is contracted to deliver this service until 31st March 2022. It is a legal requirement to conduct a procurement exercise for a contract for such a service following the expiry of the contract with CMC.

We consulted with stakeholders, including patient representatives and existing users of CMC, who stated that it is important to communicate the purpose of the care plans, which is to share patient wishes and important information with health and care services. The main use case for CMC and the principle of the care plan template at go-live is as an Urgent Care Plan.

Therefore, Urgent Care Plan is the term that will be used to refer to the care plan and application that will be available from go-live. The Urgent Care Plan fulfils the requirements of an Electronic Palliative Care Coordination System (EPaCCS).

Future care plan templates that are developed after 1st April 2022 will be named by stakeholders based on the clinical purpose of the care plan, for example a Treatment Escalation Plan or Mental Health Plan.

The programme leading the implementation of the Urgent Care Plan is called the Urgent Care Plan (UCP) Programme. This programme is hosted by South West London CCG on behalf of London. The programme oversees the following projects:

  • IT Implementation, in partnership with OneLondon and Better
  • Clinical Design & Engagement
  • Clinical Governance
  • Information Governance

The new digital provider underpinning the Urgent Care Plan is Better. An implementation project group, led by the Chief Technology officer for London has been established to oversee the implementation plan for the digital solution, to ensure that all parties bought into the requirements for the new service.

Better is a leading technology company supporting the NHS with their Digital Health Platform. The Better platform enables fast and agile creation of forms and clinical applications, separated from the data, for instant data access, re-use and expansion. The company’s solutions are putting organisations in control of their data, with the aim of simplifying the work of care teams and accelerating digital development of all data for the lifetime of the person.

In the last three decades, Better has provided solutions for more than 150 clients across 16 countries worldwide with their OpenEHR and open standards-based platform and applications, such as their Electronic Prescribing and Medicines Administration product BetterMeds. Better’s clients include Suffolk and North-East Essex ICS (SNEE). In partnership with Better, SNEE were able to create a dynamic and integrated care planning platform to enable patients and care teams to gain easy and real time read-write access to a single source of information focused on patients’ needs, anticipatory care and wishes, in 12 weeks.

All suppliers who responded to the Market Engagement Questionnaire were invited to bid. Potential suppliers were evaluated by an independent evaluation panel, using a scored evaluation framework. The framework focussed on how well the suppliers could meet the core technical requirements, such as integration with electronic patient record (EPR) systems, transition, development and implementation plans, skills and expertise, ability to meet patient use cases and the strategies to support transformation, engagement, training and partnership. Better was the highest scoring bidder, demonstrating the ability to launch Care Plans in the context of an end user EPR. The evaluation panel assessed Better to have a strong delivery team with relevant experience.

Extensive stakeholder engagement was conducted between October 2020 and March 2021 to find out what was needed from a care planning solution. Stakeholders identified the following functionalities, which Better have committed to deliver:

  • Reduced duplication: Care plans can be pre-populated with relevant information from the patient’s GP record from EMIS and SystmOne. This will reduce the need for transcription.
  • Improved accessibility:
    • Users won’t need a separate log-in to access care plans when accessing the solution via a connected Electronic Patient Record systems (EPRs). Care plans will continue to be universally accessible by all clinicians involved in a patient’s care.
    • Urgent Care Services, including the London Ambulance Services, NHS 111 and Out of Hours GP services will be able to access care plans without the need for a separate log-in when accessing care plans via their EPRs.
  • Template development: We will be able to create and edit the care plan templates, making it possible to support a greater variety of clinical pathways, including, but not limited to Urgent Care and End of Life Care.

Initially, the main difference will be that the technology underpinning the Urgent Care Plan will be provided by Better, replacing the current solution commissioned by CMC. The current care planning format and principles will be transferred to the new platform, so the majority of the care planning process will be the same. As the implementation progresses, it will also be easier for the majority of users to access to care plans. Based on the on the recommendation from a clinical advisory group, agreement will be sought to pre-populate relevant information that is recorded in GP record systems to care plans.

All existing, clinically published care plans for patients that are alive will be migrated to the Urgent Care Plan. There will be no need to transcribe existing care plans to the new solution. Access to and visibility of care plans will be tested before go-live, to ensure that no data is lost.

Draft CMC plans, outstanding myCMC requests and restricted care plans will not be migrated to the Urgent Care Plan. In order to ensure that care services are able to make the best use of care plan information from CMC, the following actions are required from GPs:

  1. Please ensure that all draft care plans are finalised and published (i.e. clinically approved) as soon as possible.
  2. Please process all outstanding MyCMC patient requests as soon as possible.
  3. Please contact patients who have a restricted record, to offer them the option for their record to be un-restricted. With your permission, CMC are able to contact the patient to do this.

Communications to notify care providers of deadlines to take necessary action and instructions for how to do this will be shared with relevant services.

Yes, all existing care plan attachments for patients that are alive, will be migrated to the Urgent Care Plan’s digital system, provided by Better. There will be no need to print these in advance. Access to and visibility of care plan attachments will be tested before go-live, to ensure that no data is lost.

Yes, all existing care plan DNACPR information, including attached DNACPR forms, for patients that are alive will be migrated to the Urgent Care Plan, provided by Better. There will be no need to print these in advance, from the existing solution. Users will also be able to print a red border DNACPR from the new solution. Access to and visibility of care plan DNACPR information will be tested before patient care plans are migrated, to ensure that no data is lost.

There is likely to be a short period of time where the care planning system will be unavailable, whilst the migration of care plans to the new system takes place. We will try to ensure that this period takes place outside of core business hours. Users of CMC will be notified in advance of the down-time period.

CMC currently provide a patient facing portal, myCMC, which was developed by CMC as part of the service roadmap. However, this service is not commissioned by South West London CCG. Further information about provision of myCMC, will be shared by Royal Marsden NHS Foundation Trust in due course.

The UCP Programme IT Implementation Project are making arrangements with the NHS App and personal health record providers to provide patients with access to their care plans.

We anticipate that the same role-based access rights will be used after transition. However, a pan-London clinical working group will review this and recommend a role-based access policy. As part of the information sharing agreements, organisations will also be asked to identify a clinical lead to oversee access to, and utilisation of care plans in their organisation.

The way users access care plans will depend on the EPR system used within your organisation. The table below outlines the access option for each phase of implementation, and the steps required to get access. The UCP Programme team will be in touch with your organisations to make necessary arrangements and to support user migration.

Users of the following EPR systems will have access via their EPR without the requirement for a separate log-in (‘federated access’), which will provide you with the same level of contextual launch.

  • EMIS
  • EMIS Community
  • TPP (SystmOne)
  • Cerner HIE
  • Advanced Adastra
  • Cleric ePCR

Users of EMIS and TPP will need to register their CIS smartcard (Care Identity Service) prior to go-live. This is currently being coordinated with ICS leads and primary care IT providers at an ICS level.

Users of the following EPR systems will be able to access the Urgent Care Plan via the local Health Information Exchanges (London Shared Care Record) or via a web portal using two-factor authentication from the point of go-live:

  • Vision
  • Cleric CAD
  • Cerner Millennium
  • Servelec RIO
  • System C Medway
  • Azeuscare
  • Advanced CareNotes
  • Allscripts Sunrise
  • Care First
  • Corelogic
  • Epic
  • iSoft iCM
  • Liquidlogic
  • Lorenzo
  • Servelec Mosaic
  • Silverlink PAS
  • SMI iCare.

Access via these EPRs will be available via your EPR without the requirement for a separate log-in (‘federated access’) as part of the digital roadmap. We anticipate these integrations will be available for these EPRs by April 2023.

Care plans can be accessed via web portal using two-factor authentication. Existing CMC users will be contacted by the Urgent Care Plan Programme to support them to register. The web portal will be available from the point of go-live?

The UCP Programme and Better are working directly with EPR system providers including EMIS, SystmOne, Advanced, Cerner HIE and Cleric to ensure that the necessary configurations are established for users to access the Urgent Care Plan from within the context of the EPR. The UCP Programme are in the process of contacting care providers that are required to support this work or make arrangements for local configurations. Please be assured that you will be contacted if any arrangements are required.

Yes! It is important that clinicians continue to plan care with their patients and record these wishes and preferences on CMC.

The information currently recorded on CMC supports clinicians, especially ambulance clinicians, to make good clinical decisions. All existing, clinically published care plans will be migrated to and accessible via the new system.

CMC staff have been offered the opportunity to transfer to South West London CCG on the 1st April 2022 to support the UCP Programme with training, engagement, and transformation. Support for training will be provided in a different way going forwards:

  • Initial system training will be coordinated by the UCP Programme, with “train the trainer” training commencing in February 2022. Organisations will be contacted in due course to make arrangements.
  • Training for new users will be delivered to individuals and organisations, via a “Train the Trainer” approach, accompanied by webinars and video training.
  • User guides developed by the UCP Programme will be available.

Clinical training and clinical engagement will be co-developed, produced and delivered by the UCP Programme, in partnership with London networks, systems and stakeholders. Organisations will need to incorporate clinical training regarding care planning within organisational training programmes. Clinical training is expected to start after the initial implementation phase.

Familiarisation sessions and resources will be available to existing CMC users, however we expect the new system to be intuitive, as the care plan format and principles will be maintained within the new platform.

The future service will continue to be funded by the five London CCGs.

The future contract will be awarded for 3 years (April 2022 to March 2025) with an option for 2 x 12-month extensions.

For any further queries relating to the Urgent Care plan programme or transition of CMC, please contact the Urgent Care Plan Programme team:

Urgent Care Plan Programme (ucp.programme@swlondon.nhs.uk)

Murrae Tolson (murrae.tolson@swlondon.nhs.uk) – Strategic Commissioner for London
Lucy Colleer (lucy.colleer@swlondon.nhs.uk) – Project Officer – UCP Programme

For information regarding local implementation, you can contact your ICS Lead:

North West London: Michelle Scaife (michelle.scaife@nhs.net)
North Central London: Patrick Schrijnen (patrickschrijnen@nhs.net)
North East London: Toyin Ajidele (t.ajidele@nhs.net)
South East London: Holly Eden (holly.eden@nhs.net)
South West London: Else Krajenbrink (else.krajenbrink@swlondon.nhs.uk) or Viccie Nelson (Viccie.nelson@swlondon.nhs.uk)

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