Introduction Deciding Right (DR) is an integrated approach to making decisions about future care. It draws together statute and good practice for ACP with children, young people and adults across all sectors of health and social care, and embeds this through shared documentation. It starts with a conversation between the professional and patient about their right to make care decisions in advance. The project is jointly hosted by three of the independent hospices in Cumbria, and is strategically linked with the 1% GP palliative care registers campaign.

Case Study We will present a case study of Betty, 76yrs, with end stage COPD and multiple co-morbidities. This is a complex case featuring repeated hospital admissions and fluctuating capacity around end of life care. Through exploring this case history we will show how DR made a real difference to choice, control and sense of self for Betty, and to the health and social care management of her care. We will demonstrate how DR was important in facilitating multi-disciplinary working and critically, cross agency information sharing at end of life.

Discussion Establishing DR shared documentation across the whole of health and social care has been crucial in rolling out ACP conversations and this approach is effecting change in organisational culture. Training and education for professionals builds capacity within the existing workforce to change current practice, and engagement with students helps to future-proof the principles of DR in Cumbria.

Learning points

1. Making ACP conversations the responsibility of all professionals is key to ensuring that conversations happen early enough in people’s journey for them to be well thought through and meaningful.

2. Agreeing and adopting shared documentation for Health, Social Care and 3rd Sector organizations is fundamental to ensuring that ACP conversations held are recorded appropriately and in a meaningful format for all concerned.