New update to the Welsh Clinical Portal (WCP) helps deliver safer, better care

Clinicians across Wales can now see a person’s future care plan (FCP) much more quickly, thanks to an update in the Welsh Clinical Portal (WCP), which they use to view a patient’s record.

Developed by DHCW with partners across NHS Wales, including health boards, trusts, patients and carer groups, the update supports safer patient information sharing and better coordinated care. It reflects how patients with serious illnesses and those receiving palliative care should receive their care.

The recent update means that all the key documents stored on a patient’s record, such as their future care plan and decisions for end-of-life care, can be opened directly from the patient record. The ‘Future Care Plan discussed’ tab at the top  of the Welsh Clinical Portal screen will appear once clicked and will highlight the relevant discussion or uploaded document. This helps clinical teams make faster decisions with confidence, especially in urgent situations.

Important discussions held with patients and families about treatments that are likely to work, as well as those that are not helpful or wanted, can be recorded in the future care plan. A patient may have written an advance decision to refuse treatment, such as cardiopulmonary resuscitation or invasive feeding tubes. However, if they lose the capacity to communicate this, clinicians may not know what was said or recorded. The FCP flag highlights and can store uploaded documents, including scanned DNACPR forms, Records of Best Interests Decisions, Advance Statements, or a Lasting Power of Attorney for Health and Welfare document. This is also important for families because it can reduce stress at difficult times by helping staff accurately and swiftly find the most up-to-date information, rather than going back to the family to ask questions or requesting paper copies of documented discussions about treatments which should or should not be used.
  
The system also shows when a document has been updated or withdrawn, which is essential as clinicians need to see the most recent conversations that have taken place with the patient and their family, as these may often change while a patient is being cared for. A document that has been uploaded in error can also be retracted using the misfile functionality.
 
Before this update, staff would typically have had to search through paper notes or check more than one electronic system to find what had been recorded. This delayed care and added pressure for families and clinical teams when decisions were time critical. The UK Covid Inquiry recommendations, as well as the Health Inspectorate Wales DNACPR Review 2024, suggested the need for better electronic patient records in relation to important forms that inform future care planning.
 
Professor Mark Taubert, Clinical Director and Consultant in Palliative Medicine at Velindre University NHS Trust and Cardiff University School of Medicine, said: “Wales has been working towards a more coordinated approach to future care planning for a long time. This update is a practical step forward; it helps clinicians find key documents in the patient record, wherever that person is being cared for, using the most up to date information. It aligns with the Six Goals of Urgent Care approach in Wales, especially for those with very serious illness and palliative care needs.
 
“As clinicians, we always strive to provide safer, more compassionate care and put the patient first. Making future care planning details easier to find can reduce the risk of unwanted, painful or distressing interventions and support decisions that align with the patient’s wishes, while easing stress for the patient, their families and staff during challenging times.”
 
A patient under Professor Taubert’s care commented: “Having all my documents in one place makes a lot of sense and reduces the amount of time I have to discuss and re-discuss the treatments I’d consider, and those I absolutely do not want, such as chest compressions and electric shocks whilst I am at the end of life.”

Dr Idris Baker, Wales’s National Clinical Lead for Palliative and End of Life Care, said: “There is a growing number of people, many of them with increasingly complex needs and circumstances, who want their voices to be heard in decisions about their care. Many take the opportunity to get their thoughts and wishes down on paper in advance and share those with us so that they can get on with life and focus on other things. This system, which makes sure that clinical staff can see that information quickly and easily when they need it to help make decisions, is an important part of our National Programme’s work to help more people get the right care and treatment, when and where they need it.”