Emergency healthcare planning within County Durham and Darlington NHS Foundation Trust: a case study of innovative practice

Abstract

The number of people in the UK living with significant, life-limiting health problems and severe disabilities is rising. As a result, robust proactive care planning and good communication of care plans across care boundaries are an increasing priority. Emergency healthcare plans are proactive care plans that are designed to communicate management plans for predictable health events and to facilitate communication and documentation of individualised treatment plans. This was evaluated within our trust through the surveying of attitudes in primary and secondary care, identifying support before implementation of emergency healthcare plans and subsequent review of outcomes. We implemented 25 plans in patients with advanced dementia, metastatic cancer, and end organ failure. All died in their preferred place of care, with most dying in the community. At 30 days after discharge, no patients had been readmitted to secondary care; at 90 days one patient had been readmitted. There seems to be substantial support for emergency healthcare plans among healthcare staff. These plans have potential to improve care for patients approaching the end of life, by supporting patients to be treated in their preferred place of care, reducing unnecessary admissions and improving communication.