The challenge of interconnected systems (e.g. 111, 999, GP accessing EOL-wishes register)

Patients' expressed wishes about care may be recorded in their notes (patient record). However when a crisis occurs, unless different systems intercommunicate well, then recorded wishes cannot be acted on by staff. The workforce needs communication support, for example patients receiving end-of-life care may have expressed a strong wish to die at home (or their relatives may have done so). However when a crisis occurs a range of organisations may be contacted first – 999, 111, GP, community nurse, etc. If these have technology-based interconnecting communication systems then the expressed wish may be identified and acted on. If not, and the crisis is serious, then the default pathway is for a patient to be taken by ambulance to A&E, admitted, where they may die in hospital.

Some of the information in this section is provided by stakeholders and expert groups, and does not necessarily represent the views of the CfWI.