Digital care and support planning standard

From diabetes to cancer and other problems, more people than ever are living with long-term conditions in the UK. As a result, there has been a national drive towards providing patients with long-term, personalised care plans.

Project overview

The PRSB is working in partnership with North West London Collaboration of Clinical Commissioning Groups (CCGs) to develop the digital care and support planning standard, so that these plans can be effectively shared between patients, carers and all the health and care professionals involved in that person's care.

Developing a standard for generic care planning, including end of life treatment, will contribute towards the creation of a more joined-up care system. Standards will also help to enable people to manage their own care, with the support of a wide range of services including GPs, hospitals, occupational therapy and social care.

The standard will help citizens and health and care professionals to get the right information when they need it, in order to personalise care, and improve the experience for the patient, their carer and their families.

While the initial standard will focus on generic care planning, there will be further developments in specialist care areas in future.

The project will build on existing national and international work on integrated care planning, linking closely with the integrated care planning collaborative, the Healthy London Partnership and the North West London Collaboration of CCGs. NHS Digital is also engaged in the project to develop technical specifications which can be implemented on health and social care IT systems.

Seeking involvement from health and social care professionals

The first phase of the project, which started in March, involves gathering evidence and good practice examples. We are currently seeking contributions from professionals across health and social care and invite you to contact us at with any examples.

The second phase of the project will begin in May, with a consultation process including workshops and a survey. We expect the final standard to be endorsed and published by the end of the year.

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3 Previous Comments:
Matthew Atkinson

Oct 06, 2017 (08:20am)

There is a huge opportunity for improving care by giving people what they want, not what the system pushes them to have. This is especially true at the end of life. People who are really involved in the decisions made about them tend to choose less invasive treatments and often focus on quality of life rather than the prolongation of life. Healthcare spending is highest in the last year of life. If these discussions were widespread, well structured and visible to all, I think there would be a reduction in spend on expensive, futile treatments, not by denying care that people would want, but by only giving people the care they do want. Here's an interesting article on what doctors choose for their own end-of-life treatment.

Dr Dominic Bray, Consultant Clinical Psychologist

Aug 29, 2017 (06:09am)

I would strongly urge that two key (and related) sorts of information about patients (and their families) are given prominence: **what really matters to them eg 'to be as independent as possible, to be an involved grandparent (ie ends not means). A language purely around 'needs' will not do as it implies passivity and invites a 'fixing' response from the professional. **what they (and their family already know) about getting to those ends (what Simon Stevens would call 'renewable energy') Once these things are understood, patients/families and the professionals involved can truly work collaboratively together... as a meeting of experts.

Julie Hunt

Jun 23, 2017 (08:12am)

This information is very useful. Thank you