1. Electronic Information Sharing & the Care Plan Management System
Presentation to PPGs Chairs’ Meeting
29th September 2015

2. Reason for the Presentation
Let the PPG Chairs know about CPMS
Begin to expand the support from PPGs
Get broader patient feedback and engagement

3. Two Minute History Driver 5 year Care Strategy – Mapping the Future
Requirement
1. Connect health & social care provision
2. Facilitate improved care from sharing
Solution = CPMS
1. Information sharing infrastructure
2. Electronic Shared care Plan
Current Status
System now live and being expanded in phases
Defined by care practitioners and the Patient Special Interest Group

4. What is CPMS?

5. Electronic Shared Care Plan Content
About the person
Basic information: name, address, GP, etc. Optional info: religion, language, access, etc.
The person’s care team = Circle of Care
Who is involved in the person’s care: professionals, family, friends, legal, the person
Care Plan Header
Preferences, power of attorney, key medical info, guidance for emergency services, etc.
Care Plan Detail
Problems/issues, goals, actions Advance and anticipatory care actions
Information from care provider systems

6. Care Plan Process Identify the need for a care plan
Obtain the person’s consent to share info
Define needs from available
info
Create and agree the care plan
Circle of Care manages the care plan

7. Key Benefits Patient centric: more involved, more in control
Single care plan: single source of truth
Improved care: same information available to everyone involved in a person’s care
More informed decision making: more information, real-time where possible, 24x7
Visible to emergency care
Consistency of approach
Avoid duplication of effort: patient and care team

8. CPMS Plans – 2015/16
Expansion to include data from the hospital, mental health, community nursing, ambulance service, GP out of hours, adult social care and learning disabilities
Push data to the ambulance service for use in emergency situations
Expansion of functionality
Start development of patient access

9. Discussion Initial feedback? Do the PPGs want to be involved and how?
How can the PPGs help to increase adoption of CPMS?

10. List of GP Early Adopters
College Practice
Aylesford
Kingswood
Lonsdale
The Mote
St James
Stockett Lane
Thornhills
Waterfield