End of Life, Proactive Care Home Visiting and Proactive

Service
Care Practice Based
Hayley Carr - Contracts Manager
GP Confederation Leads
Amaia Portelli – Joint Director of Operations

CMC – A Guide for Administrators

For the End of Life and Proactive Care (Home Visiting and Practice Based) contracts, practices are
being asked to ensure that all CMC plans are reviewed by 30th September 2020. This is because a
range of healthcare professionals including London Ambulance, OHH, A&E, St Joseph’s etc. are
accessing CMC plans on an even more regular basis during this period and are anticipating this will
only increase in the autumn and winter.

In practice, this means all ‘Actions Needed’ for all ‘Plans assigned to my organisation’ on the CMC
portal here need to be addressed. Practices who have registered patients from Sorsby and Abney
last year and who have a CMC plan need to check the correct GP practice is recorded.

This guide is to help practice Administrators support GPs in this task, including guidance on how to
set up a log in, review and make individual changes to CMC care plans.

How to set up as a user

CMC Before an administrator (or anyone else) can Follow this link to view the
Training request a CMC log-in, it is necessary to complete June 2020 webinar here and to
CMC training. download the slides, follow
the link here
The following training options count:
 Webinar held in June 2020
 CMC e-learning here (CMC102 and
CMC105 modules are particularly useful)
– register to access this here
 CMC live webinars every Tuesday at
9.30am and Thursday at 1pm - register
here.

Setting up a Once training has been completed, complete the

CMC log-in User Access Form (UAF) to request a log-in.
Administrator
Email the completed form to: UAF.doc
coordinatemycare@nhs.net

Logging in Log in to the CMC portal here. For more guidance, please see
the CMC101 training video
here

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How to review care plans with ‘actions needed’
All CMC plans need to be reviewed by 30 th September 2020. In practice, this means addressing all
the ‘Actions Needed’ for all ‘plans assigned to my organisation’.

To do this, on the home page select Plans assigned to my organisation

This will generate a list of care plans that need to have one of the actions below completed. Select
on the action and this will take you to the care plan.

 Approve = GP needs to approve a change made by an administrator to publish (so we

suggest Administrators send a task on EMIS to the ‘assigned’ GP asking them to log in and
‘approve’ the plan)
 Finalise = needs to be reviewed to publish (so we suggest Administrators review which tabs
require changes and whether they are clinical or non-clinical. If it is a clinical change, a task
on EMIS should be sent to the GP asking them to finalise the plan. If it is non-clinical change
Administrators can do this – please see below for more details)
 Review = needs to be reviewed or the review date reset to publish (so we suggest
Administrators check the assigned GP practice is correct and reset the review date for 6
months/ appropriate length).

How to make changes to individual care plans (clinical and non-

clinical)
To check the status of a CMC plan click on Update Care Plan
This will enable you to review the care plan tabs – please see below for guidance on what tabs
Administrators and GPs can provide information on and ‘approve’.

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Key (who can provide information tabs)
GP only
Administrators (approved
by GP in some cases)
CMC tabs (a breakdown)
Urgent care summary
Patient Consent
Lasting Power of Attorney
(LPA)
Patient Details
Significant Medical
Background
Preferences (preferred place
of care, preferred place of
death and patient wishes)
Cardio-resuscitation
Advance treatment plan
Medication
Contacts
Social Situation
Urgent Care Updates
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These are mostly ‘clinical changes’ which means only GPs can provide
this information and ‘approve’ the care plan
These are mostly ‘non-clinical’ changes which means Administrators
can provide the information. However, in some cases (e.g. Significant
Medical Background and Preferences) Administrators will need to ask
GPs to log in and ‘approve’ the care plan
Automatically summarises the care plan and provides alerts
GP only
This can be updated if there is information on the patient’s EMIS
record
These are automatically uploaded from EMIS, but more can be added
(e.g. 2nd address, key safe information, religion, ethnicity, preferred
language and High Intensity User status). Completion of these details
adds depth to the record. Healthcare professionals who access the
CMC plan report that they find this level of detail of great value
This can be completed by an Administrator if they have been asked to
by a clinician but the GPs will need to ‘approve’ changes
This information can be completed by an Administrator if the
information is available on EMIS and then ask GPs to ‘approve’ the
plan
GP only
GP only
Only enter allergy information
This is very important for Administrators to update (including Health
and Social Care contacts, family and neighbours)
This can be completed if useful information is available but is non-
mandatory
There is nothing to enter here but you can see Urgent Care views and
 when the record was viewed by Urgent Care
Documents Do not add documents unless they are for added information.
Colleagues in Urgent Care services are not able to see these
My CMA There is nothing to enter here for the GP practice

Recording deaths
Recording death is very important. It can be done by clinicians or administrators. Please see
CMC103 training here for more help.

 Locate care plan, enter update/edit mode

 Click Record Death on the white banner,
enter details of death (date, place and
variance, if any, are very important for
metrics and Service Providers business
reports which we provide to your CCG
etc.).
 Click the Update Death and Save blue
button (see capture) and confirm ‘ok’. The
care plan is then stamped as Deceased –
viewable immediately on lists and
searches.

After this, the broader care plan body itself cannot be edited. Within ‘Record Death’ the place of
death and free-text items can be edited. However, for an incorrect date of death, call the CMC
Helpdesk to undo this.

CMC contact details

Resources website: www.coordinatemycare.co.uk

Helpdesk: 020 7811 8513 (with 24 hours password reset)

For general enquiries/helpdesk: coordinatemycare@nhs.net

E-learning: https://cmc.learning.intersystems.com/

For any further queries, please contact Hayley Carr at hayley.carr6@nhs.net

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