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The editorial on advance care planning1 while to the point on the need in general practice to promote patients making those plans, it fails short on the most relevant issue: How the information is shared from primary care to secondary care and ambulance services. Considerable progress has been made since the initial pilots in UK in 2009-2011,2 one of them in Leeds, where it has been rolled out fully and where we are looking into possible solutions to the interoperability effect and the limiting access of the information been shared, but also going beyond looking into embedded reports to support practices implementing it.2
The editorial mentioned the CMC in England (covering 9 million people,2 although not clear on their leaflet for GPs whether systmOne practices are covered3 but fails to discuss the fact EPaCCS takes over 82 forms and there are still no clear answers to what is functional EPaCCS, how much is shared, etc.4
At the end of the day, if the information does not flow easily among the NHS organisations there is little point on UK citizens on managing early their end of life preferences and their ACPs, and they will remain far behind on their use when compared to the popularity in the USA,5 and the question of how long will take for national programs, like Summary Care Records, to take into consideration these developments, so any UK citizen, no matter where in the country they may be, will have advance care planning available in the unexpected happens.
References
1. Hamilton IJ. Advance care planning in general practice: promoting patient autonomy and shared decision making. Br J Gen Pract 2017; 67(656): 104-105.
2. Petrova M, Rile J, Abel J, Barclay S. Crash course in EPaCCS (Electronic Palliative Care Coordination Systems): 8 years of successes and failures in patient data sharing to learn from. BMJ Supportive & Palliative Care 2016; Published Online First: 16 September 2016. doi: 10.1136/bmjspcare-2015-001059
3. Coordinate my care. http://coordinatemycare.co.uk/cmc/wp-content/uploads/2014/06/cmc-general-flyer-2016.pdf (accessed 27 Feb 2017).
4. Henry, K., Kite, S., McDermott, S., Penn, N., Paul, W. The development of an electronic reporting mechanism to support the use of EPaCCS in clinical practice. BMJ Supportive & Palliative Care 2014; 4(Suppl 1): A65-A66.
5. Millares Martin P. (2011). Viewpoint - Ask if patients have living wills. GP. www.gponline.com/viewpoint-ask-patients-living-wills/article/1053055 (accessed 27 Feb 2017).