Promoting Planning Shortlist - ReSPECT
Promoting Planning Shortlist - ReSPECT
Building a Digital ReSPECT process for Scotland and transforming the emergency care experience.
The ReSPECT (Recommended Summary Plan for Emergency Care and Treatment) process is a UK wide initiative to support a person-centred and values-based approach to emergency care planning. The ReSPECT process was designed by Resuscitation Council UK to prompt and support intuitive future planning conversations about realistic emergency care preferences between an individual and their clinical team and to enable this conversation to evolve as care needs and preferences change.
Initially the ReSPECT process plan was designed as a paper document that was held by the patient. However the vision has always been for this information to be digitally held and shared across all health and care systems. Even the most person-centred and individualised future planning conversations will only work to transform care for that individual if the information can be recognised and accessed rapidly and safely in the midst of a health emergency or crisis. Crucial preferences and information about what really matters to the individual can make the world of difference to the care experience.
The ReSPECT process as one of the very first products to sit on the National Digital Platform. This challenge was taken on by the NES team who have worked closely with clinicians and stakeholders to ensure and maintain the integrity of that person-centred approach.
The National Digital Platform is part of the Scottish Government’s strategy to provide better access to health and care data: stored and shared through open standards including openEHR and FHIR. For clinical teams, ReSPECT’s user interface also follows the standard NHS design system for built-in usability and accessibility. Patient access to their own data (ReSPECT process and other data) is also in sight and is part of the Scottish Government’s Digital Front Door project.
This transformative work started 5 years ago in NHS Forth Valley as the first Board to embed the ReSPECT process, using the paper form, under the clinical leadership of Dr Lynsey Fielden. Currently the ReSPECT process is created and shared digitally across NHS Forth Valley, NHS Tayside and NHS Lanarkshire and other Health Boards due to start their digital rollout including Ayrshire and Arran, Dumfries and Galloway, Western Isles and Grampian. Together these Boards form the ReSPECT Collaborative, driving the uptake of ReSPECT and the digital application across Scotland.
Almost 1,000 people in Scotland have a ReSPECT plan – with this number growing daily. Key to this growth is the multi-disciplinary approach digital ReSPECT supports: health and care teams within primary and secondary care working together with community partners to ensure the outcome of a shared-decision making process, often including a family member or carer. Clinical teams have fed back that “ReSPECT gives patients a voice and a choice. I think that’s absolutely integral to what we’re doing that we have that voice” and patients have commented “this process helped with non-verbal communication … I was able to communicate my hopes and wishes for the future”.
ReSPECT data is currently shared with cornerstone systems such as Health Board’s Clinical Portals and GP/Docman system. Work is ongoing to share this data with the unscheduled care teams in Scottish Ambulance Service, Out of Hours GP and NHS 24 as part of the digital team’s ongoing workplan.
If Health Boards in Scotland want to use the ReSPECT process to transform emergency care planning and experience the digital part of that is ready to be embedded. Please contact Alistair.Ewing@nhs.scot if you would like more information or if you would like to join the Scottish ReSPECT Collaborative.
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