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Dying matters, but what can you do?

Patients in Waltham Forest are being given greater power to inform GPs, hospitals, ambulance crews and out-of-hours services about their urgent and end of life care wishes.

Generally, people wish to die in their own homes when that time does come, but the borough has the highest number of people dying in hospital in England. In the past year 63.4% of residents’ deaths have been in hospital compared to the London average of 52.6%.

A new online urgent care record called 'myCMC' is being introduced to help ensure patients’ urgent care needs are clear, particularly when they are treated by urgent care teams.

During Dying Matters Awareness Week (14 - 20 May 2018) Waltham Forest GPs and community nurses have been asked to work with their patients, who are already known to be nearing the end of their lives, to gain consent in creating a plan for sharing with other health care professionals.

Patients, carers and families can start the process themselves if they wish to.

Patients with a co-ordinate my care (CMC) plan can ensure everyone along their health journey knows their health problem, how they wish to be treated, and what to do in the middle of the night when their own doctors and nurses may not be available. 

Dr Mayank Shah, Clinical Director, NHS Waltham Forest Clinical Commissioning Group, said: “Creating an action plan for patients whose condition might escalate, means we can ensure they are appropriately treated and can avoid unnecessary hospital admissions.

"Frail patients, who may be coming towards the end of their lives, often do not want to be sent to A&E, they prefer to be treated in their home or care home.

"But where plans are not in place, staff and carers may panic without the right information and send patients to hospital for events that may be part of the natural process of dying.

"CMC plans can make sure important questions and discussions about the patient’s wishes are not overlooked.

The plans can help professionals understand when it is not appropriate to take patients to hospital where they may feel frightened, or when to avoid resuscitation, avoiding the unintended consequences such as cracked ribs.

"People want to be involved in the decisions about their care. Creating a CMC urgent care plan is something that stimulates discussion and gives patients more control."

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