Direct Enhanced Service Project: Care home DES (direct enhanced service) is a Macmillan initiative for GPs. This has already started but has a big emphasis on residents having an ACP/FCP in place. An annual report is submitted each year to secure funding each year and within this are figures including the number of residents where patient centred advance care planning has been undertaken. This has been running for the last 6 months. 

Palliative care toolkit pilot: Another initiative that is happening in primary care is the palliative care toolkit pilot which is running in CAVUHB and a new similar pilot that is being launched in 6 practices in ABUHB. This again has a large section concentrating on identifying patients suitable for ACP and then encouraging for it to be done with correct coding for capturing relevant data.

Dr Rachel Lee Macmillan GP Adviser for Wales