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Ensuring people’s care preferences are respected

Last summer London took its first steps beyond a read only pan-London record for frontline staff when the Universal Care Plan (UCP) for London was launched. Here Murrae Tolson, UCP Programme Director, explains why this is such a significant development that offers so much potential both now and in the future (15 May 2023).

What is the UCP and why is it important?

In July 2022 we launched the Universal Care Plan for London – with an initial focus on end-of-life plans.  

It is an NHS service that enables every Londoner to have their care and support wishes digitally shared with healthcare professionals across the Capital. 

This helps to ensure wishes and care preferences are respected – even if a person is seen by someone from outside their normal care team, for example in an emergency.

It can be accessed through both local Electronic Patient Record (EPR) systems and the London Care Record and crucially allows staff to update care plans.

Case Study

Maggie has multiple long-term conditions and frequently calls 111, 999 or goes to A&E. She would rather be spending time with her family and watching tennis. Her GP has initiated a personalised care and support plan, recorded and shared via the UCP.  Her plan can be viewed and continuously updated by any of the multi-disciplinary team supporting Maggie in one click from their EPR or the London Care Record.  When Maggie calls 111 or 999, urgent care services have holistic information to support clinical decision-making so that she can stay at home.  

How was the UCP introduced?

South West London Integrated Care System’s UCP Team, supported by OneLondon, developed and introduced this new platform across London in just seven months!!

It is delivered by Better Health and involved outstanding collaboration between thousands of London providers

Thanks to this amazing joint effort the UCP went live with no downtime, all information from the previous system successfully migrated and only one version of a person’s care plan visible throughout the transition.

This is the result of incredible collaboration between a massive range of stakeholders. Including London Clinicians, NHS England, OneLondon, the London IUC team, primary care, acute and community IT teams, technology vendors, and integrated care system networks. It will make a tangible difference for patients, with a truly joined-up approach to care.

What difference is it making?

The UCP is already making a difference by helping to ensure wishes and care preferences are respected.

  • 54,576 Londoners have a personalised care plan documented on the UCP
  • Since launch UCP care plans have been accessed 136,330 times by users from different organisations
  • 15,409 new UCP care plans were created since the launch in July
  • 37,906 UCP care plan were viewed by emergency services since the launch in July
  • 28,985 UCP care plan accesses via the London Care Record since UCP launch

But don’t just take my word for it! Let’s hear from a clinical colleague.

Dr Katherine Buxton MBChB (Hons) MA FRCP, Clinical Lead – Urgent Care Plan Programme, said:

“It is really important that we ensure that all health and care professionals involved in that person’s care are aware of their urgent care plan so their wishes and preferences can be respected.

“The new UCP platform is really helping healthcare teams with this while also saving them time. It can be accessed from within our existing electronic patient record system making it immediately accessible to all staff. As well as containing key information about patient’s wishes and preferences, it also shares a detailed care plan to help support the clinical management. This is so important in the event a person needs to be seen by a healthcare professional outside of their usual care team, as it supports consistency of care.”

What are the next steps?

The go-live of the UCP Platform was just the first step in OneLondon’s plan to digitise patient care plans and support ICS transformation across the city.

Work is underway to extend the UCP Platform from a digital urgent care planning tool to a wider digital personalised care planning solution that meets the needs of both Londoners and the clinicians who provide them with care.

Earlier this year the UCP team hosted a discovery day, involving 80 stakeholders in the process and design needed to extend the UCP use beyond Urgent Care Planning. 

Subsequently we have started scoping the work to support 12 new clinical pathways to support an additional six million Londoners with personalised care plans. 

This includes using the UCP Platform to support people with dementia, frailty, diabetes, sickle cell and other long-term conditions.

Healthcare professionals and patients are encouraged to use the UCP, even as the template evolves. The plan contains crisis care data sets, so can be used for people with long-term conditions, not just those are receiving End of Life Care.

Murrae Tolson (middle) and some of the UCP Team

It is also our ambition that patients will be able to add information about their care preferences through the NHS App.

The UCP platform really does offer so much potential to support joined up and effective care across the Capital.

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