Feature End of Life Care

Delivering a digital death

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f2528 (Published 24 April 2013) Cite this as: BMJ 2013;346:f2528
  1. Michael Cross, freelance journalist
  1. 1London, UK
  1. michaelcross{at}fastmail.fm

London patients with life limiting illnesses can now record their end of life preferences on a single electronic record. Michael Cross looks at the project’s background and asks if it can ever go national

From this summer, NHS patients in London will be able to add a new function to their mobile phones. A mobile app will give them access to their Coordinate My Care record, a service designed to ensure that people receiving end of life care get appropriate treatment from any health and social care professional they encounter—including respect for any wishes they make about resuscitation or preferences for dying at home rather than in hospital.

The app, which will also support mobile working by professionals, is the next planned enhancement for the Coordinate My Care service, which this month went live across London’s entire NHS, including an ambulance trust, 34 acute and specialist trusts, and 14 inpatient hospice units. It is a good example of the locally led information technology initiatives that are likely to become the norm in the reformed English NHS.

The drawback is that local initiatives can result in duplicated effort and create islands of information that are difficult to exploit more widely, if required.

Better coordination of end of life care has been recognised as a national priority since the publication of the Department of Health’s end of life care strategy, in 2008. Surveys consistently show that although most people with terminal illnesses wish to die at home, less than 20% of those with chronic illnesses do.1

Emma Hall, consultant in palliative medicine at St Christopher’s Hospice, …

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