This EARLY Identification and Personalised Care Planning Toolkit was developed by the End of Life Care Clinical Network (NHS England and Improvement London region). The purpose of the toolkit is to support GP practices to identify patients who might be in the last phase of life and who might benefit from an opportunity to discuss and develop a personalised care plan which could then be recorded on an Electronic Palliative Care Coordination System (for London, CMC). 

The toolkit comprises:

  1. A search tool that can be used in VISION, EMIS and SystmOne GP IT systems and uses SNOMED codes to identify those who might be in the last phase of life
  2. An interactive toolkit to guide GP practices in the implementation of the search tool, the subsequent validation of the patients identified, and the invitation for and discussions with patients and those important to them in order to develop a personalised care and support plan.

 For further information and support for implementation of the EARLY identification and personalised care planning toolkit please contact

The toolkit will continue to be reviewed; all comments and suggestions should be emailed to

The EARLY search took and interactive toolkit were developed in 2019-2020 during a national project to support earlier identification of those who may be in their last phase of life. Contributors to the project include North West Region England, the Newham CCG EOLC Clinical lead and the NHSE/I London region EOLC Clinical Network.

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