1. How to use a Yellow Folder Alicia Smith & Jo Jones ACP Facilitators Suffolk Advance Care Planning Project

2. Who should lead the discussions? Care Homes District Nurses Community Matrons Community CNS Teams (Macmillan Nurses) AHPs GPs

3. Yellow Folder Process Charts Flowcharts developed for Primary Care, Community teams, Care Homes and Hospices reflecting the individual role within the Yellow Folder process. New changes within Yellow Folder: Adapted GSF Passport Addition of a Key Contact Directory Adapted DNACPR tri-carbon form Notification of DNACPR to Ambulance Service (EEAS)

4. Adapted GSF Passport Requires a GP’s signature, agreeing to complete a death certificate for an expected death with no reportable circumstances outside of the 14 day rule to reduce unnecessary coroner reporting

5. Contact Sheet New additional sheet Directory of Key Contacts to help co-ordinate services at end of life Useful for families/carers to help prioritise which service to call in an emergency Gives other healthcare professionals, families and carers an overview of who is involved in an individuals care at end of life

6. New DNACPR Changes made by SHA as a result of feedback from road shows Tri-carbonated form with copies for the patient, clinical notes & audit SHA to send letters to all stakeholders via the Anglia Cancer Network (ACN) ACN to distribute pads of forms There is an expectation for organisations to purchase additional forms Existing DNACPR forms are still valid – current decisions do not need to be transferred onto new form Ensure that a Doctor has signed the ‘endorsement by responsible senior clinician’ section on the DNACPR form