The EIU’s recent Quality of Death report praised palliative care in the UK as the best in the world, citing the quality and availability of services provided by the NHS and hospice movement as “second to none”. Nonetheless, the report highlighted room for improvement, echoing findings of the Parliamentary and Health Service Ombudsman in England that criticised end-of-life care services.

As a clinician working on the front line of palliative care delivery there is no denying that being the best across 80 countries is a great achievement and testament to the dedicated work that goes on every day. While we should acknowledge our achievement, this is not a time to become complacent. We are good but could do better; there is a lot of work to be done to maintain that lead position.

We need to address the points that have been highlighted as areas for improvement, including better symptom control, better availability of out-of-hours cover, more flexible services and more responsive services. How do we do this when expectations are higher than ever, NHS resources are stretched and the “out of hours” period is two-thirds of the week?

In my mind there is only one solution: Advance Care Plans (ACP), and the communication and sharing of these plans digitally with the urgent care services that operate 24/7. Creating ACPs enables patients to take control and make choices with their usual doctor and nurse. Through the sharing of this information with the urgent care providers, the right care can be provided, at the right time, in the right place—24/7.  

Across London this work has already begun, with an innovative NHS service called Coordinate My Care (CMC). This coordinates the care of patients and provides them with choice and the assurance that all the healthcare professional teams involved in their care are connected and mindful of these choices, whenever they are treated.

A digital, personalised urgent care plan underpins the service. This documents a patient’s views and wishes, and can be seen by the entire multidisciplinary team involved in their care, 24/7.

The priority of CMC is to support and facilitate the provision of integrated health and social care by bridging the divide between community, acute and urgent care settings, with integration of the voluntary sector. CMC integrates care across London both in and out-of-hours, including GPs, community nurses, community palliative care teams, hospitals, hospices, social workers, the London Ambulance Service, NHS 111 and nursing/care homes. The service is clinician-led, with clinical governance embedded into its framework. 

To date, 24,676 CMC personalised urgent care plans have been created for patients. I strongly believe this model is the next phase in palliative and urgent care provision excellence. Online banking and the ATM and have given us 24/7 access to our finances.  Digital ACPs could be the answer to flexible, 24/7 patient care.

The views and opinions expressed in this article are those of the authors and do not necessarily reflect the views of The Economist Intelligence Unit Limited (EIU) or any other member of The Economist Group. The Economist Group (including the EIU) cannot accept any responsibility or liability for reliance by any person on this article or any of the information, opinions or conclusions set out in the article.