2016 NIA Fellows – Julia Riley (3/3)

A spotlight on NIA Fellow Julia Riley (3/3)

by Rebecca Wycliffe

The third inspiring woman, in this series of articles is Professor Julia Riley, a Palliative Care Consultant, Founder and Clinical Lead of Coordinate My Care (CMC), is one of the eight Fellows who joined the second cohort of the NHS Innovator Accelerator. Her aim is to improve the quality of care people receive, particularly when it comes to end of life care.

(For the 1st full piece from the series please click here)

The NHS Five Year Forward View, which was launched in 2015, set out a positive vision for the future healthcare system. A triple aim was proposed: to improve population health, quality of care and to create a more financially sustainable NHS. With an aging population, and growing number of patients suffering from long-term chronic illnesses and mental health problems, health and social care services are under ever increasing pressures. These services need to grow to meet the demand of the increasing population and changes in patient health, but with surmounting financial pressures on the NHS, more sustainable and cost-effective solutions must be found. Patient engagement and quality of care have been a key focus to enable these solutions. Supporting patients to manage their own health and giving patients more direct control over their own care could lead to higher standards of care and patient satisfaction as well as more efficient and cost-effective services[1],[2].

Many health tech start-ups are transforming health and social services across the UK and helping to meet the goals set out in the Five Year Forward View. Initiatives such as the NHS Innovation Accelerator (NIA) Programme have been launched to support healthcare pioneers develop and integrate their evidence-based innovations into the NHS in the hope that they will revolutionize health and social care services and improve patient outcomes. Over the next few weeks, I want to share with you the work of several remarkable women who have developed innovative ways to educate and encourage patients to take more responsibility and become actively involved in their own health choices, and who are ultimately providing solutions to the key challenges facing the NHS today.

CMC works to engage patients in their own health by giving them the chance to express their care preferences and make choices about the care they receive. Through discussions with doctors or nurses, patients can create a personalised urgent care plan based on their wishes about how and where they receive their care. Details of a patient’s care plan are then uploaded onto the CMC system, a common electrical record, which enables healthcare professionals who are involved with that person’s care to access the patient’s information. This could include GPs, London Ambulance services, Specialist Nurses, NHS 111 service and community nurses, to name a few. Families, friends, urgent and non-urgent care providers all play integral parts in successfully coordinating appropriate end of life care. By creating a system that stores and easily communicates vital care information between health and social care providers, people involved in a patient’s care will have the information to be able to deliver the personalised, planned urgent care 24/7. The CMC NHS clinical service gives patients more control over the care they receive and confidence in their carers to deliver the safe, appropriate and dignified end of life care that they wish for.

A few words from Dr Julia Riley on Coordinate My Care:

What was your motivation behind starting CMC?

“My sister-in-law was 32 years old. She had malignant melanoma and had been told there was no further treatment available. She had 4 children under the age of 5 years and wanted to stay at home. She was cared for by top quality teams that included the hospital, the hospice, the community nurses and her GP. During working hours she was well covered. Her illness was however unpredictable. She had brain metastases and would wake in the night in excruciating pain. The out of hours GPs or the emergency services would be called. The default was always to recommend taking her to hospital.

In retrospect, what could have overcome so many of the difficulties of her care would have been a shared urgent care plan. What to do at 2am if….pain, if…vomiting, if….distressed. A plan written with her, by the clinical staff that her knew her well and shared with all the urgent care services, would be the ‘Holy Grail’.

The staggering realisation was that the ‘Holy Grail’ could so easily be a reality, and now it is.”

How is CMC disrupting urgent care services, in particular, palliative care?

“Urgent care services are currently, and have historically, been reactive services. A patient has a crisis, the service reacts and a clinical solution is delivered. This reactive model is costly to the patient and costly to the NHS.

CMC represents a paradigm shift. It changes urgent care for vulnerable patients, who might expect a crisis, into planned care. Planned care is better for patients, carers, families and friends. Planned care is better for the NHS.

CMC delivers quality care for the NHS patient at affordable costs for NHS tax payers.”

How do you feel CMC aligns with the Five-Year Forward View?

“CMC was designed for patients, it ‘wraps’ around the patient, delivering safe and secure care night and day. The service is best delivered at a population level. CMC delivers the care that patients have chosen at a reduced cost to the NHS. As more and more patients become chronically ill with multiple morbidities, it is no longer possible for all doctors and nurses to know each individual patient. Sharing clinically relevant information with the ambulance services, NHS 111, A&Es and the out of hours GP services ensures patients receive the right care, at the right time, at the right cost.

CMC is delivering a re-imagined urgent care service. The data is compelling. CMC is a proven innovation for end of life care in London. It can easily be scaled to include all vulnerable patients in any part of the country, delivering patient focused, high quality, less costly care during the out of hours period that represents two thirds of the week.”

What are your ambitions for the CMC clinical service going forward?

“My ambitions for CMC are first and foremost to deliver better care for patients, for everyone to have a CMC urgent care plan! Who is to say that tomorrow I will not be hit by a bus? At this time of crisis, I would like my nearest and dearest to know my wishes, preferences and expectations of care. This may be dramatic. Less dramatic examples are patients who may have been diagnosed with dementia, the biggest killer in the UK today. These patients know they will lose capacity one day. Would it not be reassuring to them, and their families to know what they want when they cannot express these wishes?

My second ambition is to improve patient care through research. CMC is built on a secure information care exchange. It has the ability to collect longitudinal data, do the analytics and report on the outcomes in real time. The sky is the limit for redesigning and improving care through the understanding and sharing of best practice.”

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