Universal Care Plan (UCP)

What is the Universal Care Plan?

The Universal Care Plan (UCP) is a digital personalised care plan available across all of London. 

It captures what matters to the patient, their care preferences, and clinical updates.

It is visible in real time to London Ambulance Service, GPs, community, OOH teams and A&E departments.

It is a vital tool to enable the right things to happen especially in a crisis.

Who is it for?

Any patient who would benefit from proactive, coordinated planning.

Prioritise patients on your palliative / end of life register, frailty register, care home list, or those with frequent unplanned admissions. 

Where do I find it — do I need a separate login?

No separate login is needed for most NWL practices. Access it directly from your clinical system:

  • EMIS Web - launch via the UCP widget within the patient record

  • SystmOne - access via the integrated UCP link within the patient record

  • Web portal access - ucp.onelondon.online

How do I identify patients and create a plan?

Use the EARLY toolkit (available in EMIS and SystmOne) to flag patients who may benefit from a care planning conversation.

Then open the UCP from within the patient record, search by NHS number, and work through the template.

Save at any point — the plan is immediately visible to other services.

What are the key fields to complete

The minimum information should include CPR status, professional and family contacts plus key symptom management plans e.g. what if pain or breathing deteriorates

Who can see it and does the patient need to consent?

Yes, verbal consent is needed. ''Are you happy for me to complete an electronic care plan to keep everyone involved in your care up to date?''

It can be accessed by the London Ambulance Service, NHS 111, OOH GPs, community nursing, and hospital teams - and patients can view it themselves via the NHS App. 

When should I update it?

After any hospital or hospice admission, on significant clinical change.

Keeping it current is what makes it useful in a crisis.

 

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Related Services

Hospices

Community Palliative Care Team - based at Meadow House Hospice
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Community Palliative Care Team - based at Meadow House Hospice

T. 020 8967 5179

W. https://www.lnwh.nhs.uk/meadow-house-hospice/#community-palliative-care-team

The Community Specialist Palliative Care Nurse Team provides advice and visiting to palliative care patients in Ealing and Hounslow. The team are based at Meadow House Hospice.

The team will visit patients with progressive life limiting illness in their own homes. They provide specialist advice around pain and symptom control and support for patients, their families, and carers during the last stages of illness. They also support patients wishing to die at home through coordination with GPs and hospital teams.

The team is comprised of medical consultants, specialist nurses, physiotherapists, occupational therapists, social workers, a bereavement support officer and a patient and carer advocacy worker

The team can be contacted for referrals Monday to Friday 9.00am to 5.00pm.

Between Monday to Friday 5.00pm and 8.30am, the Out of Hours Telephone Advice line 020 8102 5000 takes calls. Weekends and Bank Holidays 5.00pm to 9.00am.

Referral form for clinician use only.

Community Specialist Palliative Care Referral Form V4.2 (DOCX)
Hospice UK
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Hospice UK can help find a hospice, provide infromation and support about end of life care and guidance to plan ahead.

Meadow House Hospice Inpatient Unit
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Meadow House Hospice Inpatient Unit

T. 0208 967 5179

W. http://meadowhouse.lnwh.nhs.uk

Meadow House Hospice provides inpatient palliative care services to the residents of Ealing.

The hospice has a 15 bedded inpatient unit supported by a team of dedicated staff providing 24/7 specialist support to patients and their family members. Patients with a progressive life limiting illness can be admitted for symptom management or end of life care.

Patients have a safe, dignified space of their own and the flexibility to spend time alone or in company, surrounded by their possessions and the people they care about. The hospice also has an extensive garden area that provides a quiet and reflective environment for both patients and family members.

Please contact the hospice Monday to Friday 8.30am to 4.30pm and during the weekend 9.00am to 5.00pm on 0208 242 5817.

There is a 24 hour telephone support line to the hospice ward on 0208 967 5597.

Bereavement services to support family members, friends and carers connected to a loved one who was cared for by the Hospice, can be contacted via main switchboard.  

Referral form for clinician use only.

Community Specialist Palliative Care Referral Form V4.2 (DOCX)

Overnight/weekend services

Planned Night End of Life Care
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Planned Night End of Life Care

T. 0203 370 2208

This is an overnight service and is provided by Marie Curie via Meadow House Hospice for residents of Ealing and Hounslow. This service provides one to one overnight nursing support, symptom control, management of pain, emotional and practical support for patients in their last few weeks of life.

Referrals are made via Local Clinical Coordination Centre Monday to Sunday from 10.00pm to 7.00am.

Marie Curie Planned Night Services Referral Form (DOCX)
Rapid Response End of Life Care Service
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Rapid Response End of Life Care Service

T. 0208 967 5126

Marie Curie Rapid Response Service provides short term palliative nursing interventions, symptom control, management of pain, advice, emotional and practical support to the residents of Ealing and Hounslow. This service is based at Meadow House Hospice.

The service can be contacted Monday to Sunday from 6.00pm to 7.00am.

Rapid Response Referral Form (DOCX)

Rapid access services

Rapid Response End of Life Care Service
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Rapid Response End of Life Care Service

T. 0208 967 5126

Marie Curie Rapid Response Service provides short term palliative nursing interventions, symptom control, management of pain, advice, emotional and practical support to the residents of Ealing and Hounslow. This service is based at Meadow House Hospice.

The service can be contacted Monday to Sunday from 6.00pm to 7.00am.

Rapid Response Referral Form (DOCX)

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