• Skip to main content
  • Skip to secondary menu
  • Skip to footer
Clinical Digital Resource Collaborative

Clinical Digital Resource Collaborative

Designed and developed in the North East and North Cumbria by local GPs

National Health Service
  • Home
  • About Us
  • Our Team
  • What We Offer
    • Primary Care
    • Commercial
  • Resources
    • Referral Forms
    • EMIS Resources
      • CDRC EMIS Access
      • EMIS: Long Term Condition (LTC) Management
      • Medicine Management
        • EMIS: Precision Monitoring Template
        • EMIS: DMARDs and High Risk Drugs
        • EMIS: Safe Prescribing of Opioids / Opiates
      • Specialties
        • EMIS: Cancer Guide
        • EMIS Cardiovascular Overview
          • EMIS: Cardiovascular Disease (AF, CHD, Hypertension)
          • EMIS: Cardiovascular Disease (CVD) Prevention
          • Lipids, Familial Hypercholesterolaemia (FH), PCSK9i & Inclisiran Guide for EMIS
          • EMIS: Peripheral Arterial Disease Guide
        • EMIS Diabetes
        • EMIS: Care for Frail Patients
        • EMIS: Haematology
        • Infection
          • EMIS: Infections Guide
          • EMIS: Blood Borne Virus (BBV)
        • EMIS: Learning Disabilities
        • EMIS: Neurology Guide
        • EMIS: Paediatric Assessment
        • EMIS Renal Overview
          • Chronic Kidney Disease (CKD) – EMIS
        • Respiratory Overview
          • EMIS Respiratory Resources
          • BeatAsthma+ Guide for EMIS
        • EMIS: Rheumatology
    • SystmOne Resources
      • National Early Warning Score 2 (NEWS2) Guide for SystmOne
      • Getting Started
        • Getting Started – Access
        • Getting Started – How-To’s
      • SystmOne Administration
      • Contract Management
        • Impact and Investment Fund (IIF)
        • Quality and Outcomes Framework (QOF) Guidance for 2023/24
      • Long Term Condition Management
        • Call/ Recall System
        • Recall Recovery System
        • Care Planning
      • SystmOne Safeguarding System
        • Safeguarding Adults
        • Safeguarding At Risk of Harming Others
        • Safeguarding Family/Household Cause for Concern
        • Safeguarding Children
      • Medicine Management
        • Drugs Requiring Monitoring System
        • SystmOne: Antibiotics Prescribing & Optimisation
        • Safety & Reviews
        • Safe Prescribing of Opioids / Opiates
        • Safe Prescribing of NSAIDS
        • Safe Prescribing of Lithium
        • Safe Prescribing of Valproate
        • Safe Prescribing of Corticosteroids / Steroids
      • Specialties
        • Blood Borne Virus (BBV) Test Alert for SystmOne
        • BeatAsthma+ Guide for SystmOne
        • Cancer Overview
          • Cancer
          • Suspected Cancer
        • Cardiovascular Overview
          • Cardiology Results
          • Hypertension & Blood Pressure
          • SystmOne Heart Failure
          • Atrial Fibrillation (AF)
          • Integrated CVD Prevention
          • Peripheral Arterial Disease (PAD)
        • SystmOne Diabetes Overview
          • SystmOne Diabetes Management
          • SystmOne Diabetes
          • SystmOne Diabetic Kidney Disease
        • ENT Infections
        • Geriatrics Overview
          • SystmOne: Care for Frail Patients
          • Comprehensive Geriatric Assessment
          • Co-ordinated Care
        • Haematology
        • Infection Overview
        • Learning Disabilities
        • Lifestyle
        • Lipids, Familial Hypercholesterolaemia, PCSK9i & Inclisiran Overview
          • Lipids, Familial Hypercholesterolaemia (FH), PCSK9i & Inclisiran Report Guide for SystmOne
          • Lipids Protocols
          • Lipid Management Templates
          • Lipid QoF Support
          • Screening for Familial Hypercholesterolaemia
          • Aetiology of Abnormal Lipids
          • Lipids Strategy
        • MSK Referral Management
        • Neurology
        • Obesity Resources
        • Ophthalmology
        • Palliative Care
        • SystmOne Renal/Urology Overview
          • Chronic Kidney Disease (CKD)
        • Respiratory Overview
          • Asthma Resources
          • Respiratory Infections
        • Rheumatology Overview
          • SystmOne: Osteoporosis and Fragility Fractures
          • Bone Health
      • Women’s Health Overview
        • Gynaecology Resource Overview
          • Cervical Screening
          • Contraception
          • Prolapse
        • 6-8 Week Postnatal Check
      • Vaccination Overview
        • COVID-19 Resources- SystmOne
        • Influenza Vaccination SystmOne
        • Meningitis B Vaccination
        • Meningitis ACWY Vaccination
        • Pneumococcal Vaccination
        • Shingles Vaccination
  • FAQs
  • News and Events
    • Demonstrations
    • Events
      • Recordings
    • Articles
    • Conference abstracts
  • Contact us
You are here: Home / Resources / SystmOne Resource Centre / SystmOne Specialties / Palliative Care

Palliative Care

CDRC’s Palliative Care resources are highlighted below.

Accessing CDRC resources on SystmOne

To access the below resources you will need to be a member of the DCS group on SystmOne. To do this, please follow the instructions on the CDRC SystmOne Access webpage.

Palliative Care Register

Patients on the Palliative Care Register will have the following icon  

Clicking on the palliative care icon will open the Palliative Care template. Alternatively, press F12 type in ‘Palliative Care CDRC’, press Search and select the aforementioned template:

Home 
els Profs Problems 
Palliative Care 
Palliative Care Summary 
Old Pall Care Template 
Palliative Care Recall 
Discussion 
MDT Meeting 
GSF status 
" Change SCR Consent 
QI soo 
Karnofsky Score 
Depression Anxiety Sc 
Summary Relatives Discussion Resources 
Palliative Care Summary 
Palliative Care Summary 
Cohorts 
Metastatic prostate cancer - hormone sensitive gleason 7 diagnosed May 201 4 
Bone and nodal mets 
Lifelong ADT, 4 weekly bisphosphonates for bone paim 
Palliative OXT - R humerus Aug 201 4 
CR Pain in Palliative Care 
Date 
15 Oct 2018 
01 Oct 2018 
- 2018 
GSF status - Blue 
Coordinated Care 
Discuss 
Selection 
Remains 
Impress'. 
be havinc 
replacem 
Has noth 
radiology 
Ongoing 
waking hi 
Due to ha' 
infusions 
There are 
discussic 
xrau/ 
SCR Additonal Information NOT shared - preference no 
03 sep 2018 PHCT me 
from SRF 
with fast; 
Getting al 
from psyc 
support'* 
Is now off 
NO record of DS1500 discussion 
Australia-modified Karnofs„ 60 % 
NO record of depression screen 
18 Oct 2018 
Palliative Red Kardex 
Resusctation 
ppc 
PPD 
Carers 
CPR Status not recorded 
Preferred place of care preference not recorded 
Preferred place of death preference not recorded 
No information about EHCP 
No Record of ADRT 
No recorded information about carers 
LPA/MCADOLS 
Safeguarding 
NO personal welfare attourney recorded 
No record of 'MCA 
NO record affairs under court jurisdiction 
Not currently recorded as subject to a DOLS Ord. 
NO record of current safeguarding concern 
@ Show recordings from 
Show empty recording±

This screen shows: 

  • A thumbnail sketch of the most important information. 
    • To create the thumbnail click the Palliative Care Summary button, complete the questionnaire entry and then choose Save Final Version when complete. 
  • The earliest pending Palliative Care  or Coordinated Care recall 
    • This allows a system to review relevant patients at appropriate intervals 
  • A box to record any current discussion or events 
    • Previous entries are shown down the right hand side so the narrative can be followed. 
  • Current GSF status and drop down box if status has changed 
  • Current SCR with Additional Information sharing status and button to change preferences 
  • Most recent information about DS1500 and link to DS1500 template 
  • Most recent performance status score 
    • The most recent score out of Karnofsky, modified Karnofsky and WHO status is displayed. 
    • New scores are recorded with the regionally agreed modified Karnofsky score 
    • Right clicking on the score and choosing Graph Values will display previous values to allow trend to be seen. 
  • There is a link to the detailed regional guidance on pain management in palliative care including  
  • Clicking the Palliative Red Kardex button allows creation of the County Durham and Darlington Palliative Kardex. 
  • The bottom panel shows important information such as patient preferences for place of care and death, resuscitation information, EHCPs and other important legal information. 

Other pages on the template show: 

  • Relatives’ information 
  • Involved professionals 
  • Medical Summary 
  • Summary of discussion with relatives 
  • Useful resources (below)  
Palliative Care Resources 
O GSF Guidance 
North Enaland Networks Palliative Care Guid 
RCGP Palliative care and EOL Toolkit 
Decidina Riaht Guidance 
Best Interests Decisions in Care Crises in Adults 
EHCP Guidelines 
Printable Forms - for paper completiom 
For electronic completion use the rest ofthis template 
NEAS Form 
ONACPR Form - MUST BE PRINTED IN COLOUR 
AORT Form 
MCA 1 and 2 Form - for best interests decisions 
Summary of GSF Indicators
Palliative Kardex

Preparation 

To use the palliative care Kardex you will need either: 

A colour printer  

OR 

A supply of paper with a red border (this link provides a word document that can be printed on a colour printer to create paper that can be used in a black and white printer) 

To Create A Kardex 

Open the Palliative Care Kardex – CDRC template (there is a link on the front page of the Palliative Care template). Alternatively, with the Patient record retrieved, in the lower left hand corner there is a search bar, type in ‘Death – CDRC’ and select that template.

If the right hand panel is blank, click the Choose palliative care medication button 

If there is currently recorded palliative care medication, this will be displayed in the right hand panel. If this information needs to be updated, right click on the panel and choose Copy questionnaire then Copy comments. Alternatively a completely blank questionnaire can be opened by clicking the Choose palliative care medication button. 

Complete the questionnaire selecting the relevant medications, dosages, routes and frequencies.  Preset answers are available for the dosages, using the commonest starting doses for each particular drug.  If a drug, dose, route is not available, leave the entry blank and the information can be added to the kardex manually. 

Page 1 of the questionnaire is as required medication 

Page 2 of the questionnaire is regular medication 

Once the questionnaire is complete click Save Final Version THIS IS VERY IMPORTANT – THE KARDEX WILL NOT WORK IF YOU DO NOT DO THIS 

Click one of the Palliative Kardex buttons depending on whether you have a colour printer or not.  Then click Write Now. 

You can edit the information on the kardex but it is generally better to edit the information within SystmOne when you complete the questionnaire so it is recorded if you need to recreate or amend the Kardex later. 

Press Ctrl-P to print the Kardex 

Click the Save Final Version button once you have finished the kardex to save a copy in the patient’s record. 

You will need to sign the kardex 

The additional buttons on the kardex template will allow you to prescribe the commonest palliative care drugs.  They are preset to the usual starting doses and will need to be amended as appropriate. 

Death Template

How to Access:

With the Patient record retrieved, in the lower left hand corner there is a search bar, type in ‘Death – CDRC’ and select the following template:

Alternatively, press F12 and type in ‘Death – CDRC’ in the search bar, this will return the aforementioned template.

Death Template:

The Death template facilitates viewing and recording of death preferences, recording of important information after death, access to information about Verification of Death, completing the MCCD (Death Certificate), Notification to Coroner, Cremation issues and creating a digitally signed cremation form 4. 

The home page of the template shows key information that might be recorded before and after death.  The latter will be helpful when completing a death certificate (MCCD) and cremation form 4. 

Clicking on the Cremation Form 4 page will open a pre-populated form 4.  In addition to demographics and the users details, the following information will also be prepopulated if it has been completed,: 

  • Date and time of death 
  • Cause of death 
  • Persons present at moment of death 

Details on how to create a Digital Signature to sign SystmOne Word documents can be found in the How Tos section of this manual 

Important implants are shown next the cremation button.  NB do not rely on this box to confirm absence of important implant as they may not have been coded appropriately  

Death Verification of Death 
Death 
Preferred Place of Death 
ICremation or Surial 
Preferences for death and dying 
Record 
MCCO 
Notification to Coroner 
Cremation Issues 
Donation 
18Ju12018 
Preferred place of death: home (XaJ3g) 
DCS Death Wishes view has no data for patient 
DCS Donor Status view has no data for patient 
Wishes to be donor 
Wishes to donate body to medical research 
Use "Patient Details" screen to enter date and time of death 
Place of Death 
Persons Present at 
Cause of Death 
Complete Cremation Form 4 
Patient Details 
OCS Death 
OCS Death 
- Place view has no data for patient 
- Persons Present view has no data for patient 
DCS Occupation view has no data for patient 
DCS Death - Cause Questionnaire view has no data for patient 
Record of RADIOACTIVE IMPLANT 
If there is a record of an intramedullary nail, t must be removed if t is a fixion nail 
Other cremation information

Verification of Death 

This page shows the key requirements for verifying death and a link to guidance for carrying this out in an emergency (e.g. pandemic) including by video link. 

Death Verification of Death MCCO 
Verification of Death 
Notification to Coroner 
Cremation Issues 
Verification of death in an emeraencv 
Verification of Death 
No response to verbal stimuli 
No response to pain 
No carotid pulse 
Pupils fixed and dilated 
No heatl sounds for 2 minutes 
No respiratory sounds for 3 minutes

MCCD 

This page shows guidance for completing the Medical Certificate Of Cause Of Death during the COVID19 pandemic 

Death Verification of Death Notification to Coroner Cremation Issues 
Medical Certificate of Cause of Death 
Guidance For Completion of MCCO Durina Pandemic 
Following the Coronavirus Act 2020, the following rules apply to death certificatiom 
• Any doctor can complete the MCCO ifthe patient has been attended in the 28 days before death or any time after death 
• If a non-attending doctor completes the MCCD, the name and GMC number ofthe attending doctor should be entered in the 'last seen alive' sectiom 
What counts as attendance? 
• Before death: face-to-face or video consultation; not telephone (as at 28/4/2020) 
• After death: the Registrar General's opinion is that only 'in person' attendance counts (as at 28/4/2020) 
Medical practitioners are required to certify causes of death "to the best oftheir knowledge and belieft Without diagnostic proof, if appropriate and to avoid delay, medical 
practitioners can circle '2' in the MCCO ('information from post-mortem may be available later') or tick Box 8 on the reverse ofthe MCCO for ante-mortem investigation. For 
example, if before death the patient had symptoms typical of COVID-I g infection, but the test result has not been received, it would be satisfactory to give 'COVID-I g' as the 
cause of death, tick Box 8 and then share the test result when it becomes availab14 In the circumstances ofthere being no swab, it is satisfactory to apply clinical judgement

Notification to Coroner

This page shows guidance on which cases should be discussed with or referred to the coroner.  If your area’s referral form have been provided it can be accessed from this screen. 

Death Verification of Death MCCO 
Notification of Death 
Notification to Coroner 
Cremation Issues 
Mod Guidance For Notification of Deaths 
Circumstances in which a death notification should be made 
Poisoning including by an otherwise benign substance (acute poisoning - not chronic alcohol or tobacco use) 
Exposure to, or contact with a toxic substance 
Due to the use of a medicinal product the use of a controlled drug or psychoactive substance 
Violence, trauma or injury 
Self-harm 
Neglect including self-neglect 
Due to a person undergoing any treatment or procedure of a medical or similar nature 
Injury or disease attributable to any employment held by the person during the person's lifetime 
Death was unnatural but does not fall within any ofthe above circumstances 
Cause of death is unknown 
Death while in custody or otherwise in state detention 
There was no attending registered medical practitioner, and there is no other registered medical practitioner to sign a medical certificate cause of death in relation to the 
deceased person 
Neither the attending medical practitioner, nor any other medical practitioner able to sign the medical certificate cause of death, is available within a reasonable time ofthe 
person's death to sign the certificate of cause of death 
The identity ofthe deceased person is unknown 
Notification form - County Durham and Darlingtori

Cremation

This page shows information about implants that must be removed before cremation and guidance about completion of cremation form 4 during the coronavirus pandemic. 

Cremation Guidance For Medical Practitioners - during coronavirus pandemic 
Cremation Form 4 can only be completed ifthe patient has been attended in the 28 days before death or seen after death 
Cremation Form 4 can be completed by any medical practitioner if it is impractical for the attending practitioner to do so 
If a non-attending doctor completes the form: 
ere you the deceased's usual medical practitioner? 
lease state how long you attended the deceased during their last illness? 
lease state the number of days and hours before the deceased's death that you last 
aw them alive? 
lease state the date and time that you saw the body ofthe deceased and the 
xamination that you made ofthat body 
rom your medical notes, and the observations ofyourself and others immediately 
efore and at the time ofthe deceased's death, please describe the symptoms and other 
onditions which led to your conclusions about the cause of deattm 
Implants that can cause problems during cremation: 
Pacemakers, Implantable Cardiovener Defibrillators (ICDs) 
Cardiac resynchronization therapy devices (CRTDs) 
Implantable loop recorders 
nswer 'NO' (enter 'Certifying doctor' in role ifyou 
id not attend the deceased at any point) 
ecord the name and GMC number ofthe doctor who 
ttended within the past 28 days, the DATE the 
eceased was seen and a summary ofwhat was 
ntered in the record by the attending doctor 
Ventricular assist devices O/ADs) Left ventricular assist devices (LVADs), Right ventricular assist devices (RVADs), or Biventricular assist devices 8iVADs) 
Implantable drug pumps including intrathecal pumps 
Neurostimulators (including for pain & Functional Electrical Stimulation) 
Bone growth stimulators 
Hydrocephalus programmable shunts 
Fixion nails 
Any other battery powered or pressurised implant 
Radioactive implants 
Radiopharmaceutical treatment (via injection)

Footer

Follow us on social media

  • Facebook
  • LinkedIn
  • Twitter
contact-cdrc@healthinnovationnenc.org.uk
This website is operated by Health Innovation North East and North Cumbria. Suite A, 2nd Floor, 1 Citygate, Gallowgate, Newcastle upon Tyne NE1 4WH. Registered in England and Wales, Company Registration Number: 08727658
  • Terms of Reference
  • Privacy policy
  • Terms of use
  • Cookie Policy (UK)
  • Accessibility Statement

Copyright © 2025 Clinical Digital Resource Collaborative

Manage Consent
We use cookies to optimise our website and our service.
Functional Always active
The technical storage or access is strictly necessary for the legitimate purpose of enabling the use of a specific service explicitly requested by the subscriber or user, or for the sole purpose of carrying out the transmission of a communication over an electronic communications network.
Preferences
The technical storage or access is necessary for the legitimate purpose of storing preferences that are not requested by the subscriber or user.
Statistics
The technical storage or access that is used exclusively for statistical purposes. The technical storage or access that is used exclusively for anonymous statistical purposes. Without a subpoena, voluntary compliance on the part of your Internet Service Provider, or additional records from a third party, information stored or retrieved for this purpose alone cannot usually be used to identify you.
Marketing
The technical storage or access is required to create user profiles to send advertising, or to track the user on a website or across several websites for similar marketing purposes.
Manage options Manage services Manage {vendor_count} vendors Read more about these purposes
View preferences
{title} {title} {title}