G510 Does clinical governance apply to the advance care plans

Background The mainstay for the Advance care plan (ACP) documentation in the United Kingdom, is a policy statement issued by the working group for the Child and Young Person’s Advance Care Plan Collaborative. This includes pro forma, information leaflets and current laws related to this very sensitive issue. Aim To standardise the practice of Advance care plans in the West Midlands and identify potential areas of improvement. Methods We surveyed Paediatric Consultants in the West Midlands Deanery using an online tool ‘Survey Monkey’. Results 40 consultants have responded to the survey request. 100%, of them have confirmed using Trust approved proforma for doing ACPs. 87%, reported that ACPs were initiated by the lead clinician. 92%, reported that they keep the General Practitioner, Ambulance and Hospice in-loop about the ACP and review them annually. 87%, of the responders currently have fewer than 9 patients on the ACPs. 50%, reported spending about 2–4 hours in preparing an ACP. On the flip side, only 45% reported using an Incident reporting system for documenting deviations from the ACPs. Astonishingly, over 80% reported that ACPs are not audited in their trust. Conclusion Our Survey has revealed that all the responding consultants practising in the region are familiar with the ACPs and use approved proforma to do so. Most of the ACPs are initiated by the lead clinician and shared with the other relevant agencies. Just under half of the responders use Incident reporting system to document deviations from the plan. Over three quarters of the responders reported that the ACPs are not audited in their trust. Recommendations Considering the enormous ethical and legal implications, we strongly feel that the process of Advance care planning should be robust. Thus, Clinical Governance tools like Audit and Incident Reporting should be used more efficiently to facilitate this.