Background Shared care records is identified as one of the foundations to achieving the Ambitions for Palliative and End of Life Care (National Palliative and End of Life Care Partnership, 2015). Electronic Palliative Care Co-ordination Systems (EPaCCS) are one vehicle which enable the recording and sharing of people’s care preferences and key details about their care at the end of life. In North Central London (NCL) Coordinate My Care (CMC) has been adopted as the EPaCCs used across services and providers. Since January 2019 the community teams in the Boroughs of Barnet, Enfield and Haringey have undertaken a digital change project to improve use of CMC.

Objective To identify the challenges and enablers to achieving digital change.

Method Activity data provided by CMC was reviewed and evaluation of the ways in which digital change had been achieved is presented.

Results Since January 2019 for the Borough of Barnet the records created have more than tripled compared with the same time in 2018. Key themes in digital change management were explored according to the model suggested by the King’s Fund (Maguire, Evans, Honeyman & Omojomolo, 2018).

Leadership and management: strategic leadership:

• Commissioning– LPoL (Last Phase of Life) Programme;

• Key Performance Indicator;

• Objective setting: Teams and individual;

• Project management;

• Barriers or enablers for change identified;

• Clinical Leaders identified;

• Data – close the loop – identify individual champions and individual support needs.

Resourcing and skills:

• Financial investment;

• Technical access and support;

• Working with CMC access issues.

Information governance:

• Information Governance Framework;

• Consent – Information leaflets;

• Communication skills around data sharing and benefits;

• New starters, transfers and leavers;

• Legitimate access;

• Auditing.

User engagement:

• Clinical champions;

• Celebration of successes – Data;

• Considering less successful outcomes – what can be improved (multi–agency);

• Incentivisation;

• Whole team – multidisciplinary team, colleagues;

• Patient engagement – MyCMC (My Coordinate My Care).

Partnerships:

• Urgent care system: London Ambulance Service, GP Out of Hours, local Palliative Care Support Service and acute sector;

• Patient engagement – MyCMC.

Conclusion To achieve digital change multiple enablers need to be undertaken to achieve change and the success is reflective of the multiple-pronged response.