Somerset launches electronic treatment escalation plans

Somerset has launched a feature which enables residents to record their care preferences within the region’s shared care record.

The Somerset Integrated Digital e-Record (SIDeR+) provides a view only summary of records held about a patient by key Somerset providers.

An Electronic Somerset Treatment Escalation Plan (eSTEP) feature went live in May 2025, allowing residents’ care preferences to be visible within the record.

The electronic plan is designed to replace the paper-based Somerset Treatment Escalation Plan (STEP), which contains details of residents’ treatment decisions on topics such as hospital admission, escalation of care, and cardiopulmonary resuscitation (resus) status.

This is especially relevant for people nearing end-of-life or with long-term conditions, frailty, or complex care needs.

Dr Charles Davis, consultant in palliative medicine and associate medical director at Somerset NHS Foundation Trust, said: “Best practice already dictates that everyone over the age of 18 should have a STEP in place.

“SIDeR+ enables this STEP to be stored and shared securely via an eSTEP, and in an emergency or crisis situation, a person’s resus status is often the most valuable piece of information to be aware of, and digital sharing of resus status is vitally important across our rural county and services.

“This significantly improves the point of crisis for everyone involved, facilitating holistic decision making alongside key medical plans.”

The electronic plans can be viewed in the shared care record by health and care professionals, including GPs, hospital clinicians, community teams and social workers.

Key information is also shared with the Southwest Ambulance Trust and with out-of-area organisations via the National Record Locator Service.

Technology partner Black Pear has made eSTEP available for out-of-county patients, to help ensure equity of access and continuity of care across geographical boundaries.

More than 5,000 eSTEPs have been completed to date, with around 2,500 eSTEPs completed before the formal launch in May.

The benefits of eSTEP include automatic updates to GP records when a form is created or changed, the reduction of unnecessary hospital admissions by aligning care with patient choices, and admin efficiency savings estimated to be at least £2,000 per month.

NHS Somerset Integrated Care Board announced in February 2024 that Black Pear had been awarded a five plus two-year contract as the technology partner for the SIDeR+.

It followed the SIDeR contract with Black Pear which began in 2018 and ended in April 2024.

SIDeR+ launched in April 2024 to build on the original SIDeR service, which went live in April 2019.

In July 2024 SIDeR+ was connected with TPP’s SystmOne primary care records in Dorset, enabling Dorset patients’ GP data to be accessed through the SIDeR+ service.

The integration allows Yeovil Hospital clinicians to create and share care plans from SIDeR+ with GP practices in Dorset, improving care coordination.

In December 2023, the Better Meds electronic prescribing and medication administration solution was integrated with SIDeR+, allowing hospital records to automatically be populated with medication information from GP and other care provider records.