Somerset ICB's Electronic Treatment Escalation Plan — Shortlisted for an HSJ Award

We're proud to share that our partner Somerset Integrated Care Board has been shortlisted for an HSJ Award for their Electronic Treatment Escalation Plan (eTEP) — a service powered by Black Pear's SIDeR shared care record platform.

The eTEP enables clinicians across Somerset to access and act on a patient's treatment preferences at the point of care, ensuring that the right decisions are made at the right time — wherever that care takes place. Being shortlisted for an HSJ Award is a fantastic recognition of the clinical teams and commissioners who have delivered this outstanding service.

We couldn't be more proud to support a team that has delivered such remarkable results. We wish the entire Somerset team the very best of luck on the night — the results they have achieved speak for themselves and are a tremendous testament to what can be accomplished when clinical ambition meets the right digital infrastructure.

Watch: The electronic Somerset Treatment Escalation Plan (eSTEP) on SIDeR+

A 7-minute case study from NHS Somerset Digital featuring Dr Matthew Dolman and the eSTEP/SIDeR+ programme team.

Summary of the video

Video info

• Channel: NHS Somerset Digital
• Featured speaker: Dr Matthew Dolman, a GP with 30 years' experience in Somerset
• Duration: 7 minutes
• Format: Service overview and implementation case study with staff testimonials

Key data points

Organisations featured

• NHS Somerset Digital — publisher of the video
• SIDeR+ (spoken as "Cider Plus") — the API-based shared care record and forms engine that powers eSTEP
• Somerset Foundation Trust — uses eSTEP and dashboards for quality improvement
• St Margaret's Hospice, Somerset Council, Somerset GP practices, nursing and care homes — connected users
• Ambulance and urgent care services — cited as beneficiaries of point-of-care access

Key takeaways

• Digitising TEPs improves consistency and availability. A single digital version creates one source of truth that's accessible across health and social care — including in rural and out-of-hours contexts.
• Change management was the hardest part, not technology. The programme took years largely because of clinical workflow change and stakeholder buy-in, supported by process mapping and strong project management.
• Shared records reduce duplication. Each time an eSTEP is created or updated, a copy is automatically sent back to the GP record in real time, saving time and reducing repeat documentation.
• Supports person-centred care. Patients can feel confident that professionals across services understand their wishes, avoiding repeated difficult conversations.
• Clinical value in urgent situations. Examples include avoiding unnecessary hospital conveyance when the plan indicates a preference for home-based care, and rapid confirmation of DNACPR wishes during acute deterioration.
• Quality improvement loop. Dashboards allow teams (e.g., within Somerset Foundation Trust) to review and improve the quality of escalation plans through training and targeted interventions.
• Equity and inclusion. eSTEP is intended to be usable for all Somerset residents regardless of background, improving sharing of key wishes across the system.

About SIDeR+ and Black Pear's role

Somerset's Integrated Digital e-Record — SIDeR+ — is a Black Pear shared care record platform that has been in continuous development with Somerset ICB since 2019, when it first went live as an Electronic Palliative Care Coordination System (EPaCCS). It expanded into a full shared care record in 2020, and eTEP is the latest clinical service to run on top of it.

SIDeR+ is, to our knowledge, the UK's only shared care record delivering real-time, structured data from EMIS, SystmOne and community systems across an entire integrated care system. Its API-first architecture — built on HL7 FHIR® standards, which Black Pear was the first UK company to adopt — means information entered once (an eTEP form, a palliative care plan, a referral) is written back to the originating GP or community record automatically, without duplication or re-keying. Nearly 4,900 health and social care staff rely on it today, with over 71,000 accesses each month.

As Somerset ICB's long-standing technology partner, Black Pear works alongside clinical and operational teams across the system to design and deliver digital services that fit the workflow rather than the other way around. eTEP is a product of that partnership — and Somerset's HSJ shortlisting is a reflection of the clinical leadership, the commissioners, and the programme's disciplined focus on outcomes.

Glossary

• Treatment Escalation Plan (TEP) — A documented plan recording what treatments are appropriate if a patient deteriorates, aligned with their goals and clinical context.
• eSTEP — The Electronic Somerset Treatment Escalation Plan; Somerset's digitised TEP, shared via SIDeR+.
• DNACPR — Do Not Attempt Cardiopulmonary Resuscitation; a decision about whether CPR should be attempted if the person has a cardiac arrest.
• Advanced Care Planning (ACP) — Conversations and documentation about a person's preferences for future care, especially if they may lose capacity or become more unwell.
• Shared Care Record — A digital record allowing authorised professionals across organisations to view relevant patient information to support joined-up care.
• EPaCCS — Electronic Palliative Care Coordination System; the first SIDeR service, live from 2019.
• Write-back — The capability where information entered in one system (e.g., a shared form) is automatically sent back into another (e.g., the GP record), reducing duplication.