Why Oliver is on the list
- Record review
- Review recommended
- Unplanned hospital episodes
- 1 in the past year
- Most recent 16 Aug 2026
- Care planning
- No advance care plan
- Not on the palliative care register in this record source
1 indicator present in the record
Unplanned hospital attendance on 16 Aug 2026: Oliguria, weakness and worsening peripheral oedema
Shaped after SPICT general indicator (service use) REC_ADMISSION_RECENT
Recorded 16 Aug 2026
Screening
No screening has been run for this patient.
Record review
The record supports a prompt clinical review for a goals-of-care conversation.
Prompt human review for a proportionate, patient-led goals-of-care conversation is supported, preferably after immediate assessment of potentially reversible acute illness. The record shows a longitudinal change from fatigue and ankle oedema to reduced urine output and worsening oedema, followed by arrival at an acute medical unit with weakness and oliguria on the cutoff date. Renal and electrolyte abnormalities add concern, but the snapshot does not establish an irreversible or life-limiting trajectory and does not document baseline function, diagnoses beyond the stated chronic kidney disease review, treatment response, or the patient's wishes.
Show the full review
This recommendation is to offer planning around priorities, not to infer outlook or limit active treatment.
What the record shows
Escalating symptom burden
Fatigue and ankle oedema were followed by earlier and worsening swelling, reduced urine output and weakness, supporting timely review while allowing for reversible causes.
2 sources in the record
- Eligible12 May 2026
Initial GP symptom record notes fatigue and evening ankle puffiness.
- Eligible24 Jul 2026
Later GP record notes reduced urine output, earlier leg swelling and intermittent light-headedness.
Acute-care escalation at the cutoff
Arrival at an acute medical unit for oliguria, weakness and worsening oedema creates an appropriate opportunity for a senior clinician to assess reversibility and ask whether the patient wants a priorities-focused discussion.
1 source in the record
- Eligible16 Aug 2026
Attendance is at the arrived stage in the acute medical unit, acuity 2, under the acute medical team.
Renal and electrolyte abnormalities
Hyperkalaemia and impaired renal indices in June, followed by raised urea and creatinine in July, warrant active clinical review; they increase concern but do not by themselves establish irreversibility.
2 sources in the record
- Eligible29 Jun 2026
Renal panel records potassium 5.8 mmol/L, urea 11.8 mmol/L, creatinine 140 micromol/L and eGFR 45 mL/min/1.73m².
- Eligible14 Jul 2026
U&E panel records urea 10.1 mmol/L and creatinine 112 micromol/L.
What they and their family want
- Telephone is recorded as an administrative contact preference; confirm whether this remains the patient's preference and whether it applies to sensitive discussions.
- The patient's priorities, understanding, decision-making capacity at the acute presentation, preferred participants and permission to involve family are unknown.
- Family, carers, next of kin, proxy decision-makers and any legal authority are not documented in the snapshot.
- The existence of care-planning documents outside the eligible snapshot is unknown.
2 sources in the record
- Eligible6 Jul 2026
Administrative observation records telephone as the contact preference.
- Eligible
No patient or family wishes, named family or carer, proxy authority, or legal care-planning document is present in the available resources.
Care at present
Unknown; no residence or usual care setting is documented in the available snapshot.
Unknown; the snapshot does not document usual activities, mobility, frailty, cognition, personal care needs or change from functional baseline.
- At the cutoff, the patient had arrived at an acute medical unit under the acute medical team.
- The longitudinal snapshot includes GP encounters and diagnostic blood testing.
- Usual residence, mobility, function, cognition, frailty and activities of daily living are not documented.
- Medication, full problem list, recent treatment changes and acute assessment findings are not documented.
- Family or carer availability and community support are not documented.
2 sources in the record
- Eligible16 Aug 2026
Attendance places the patient in the acute medical unit under the acute medical team at the cutoff.
- Eligible
The snapshot includes GP encounters and diagnostic reports but no structured residence, function, mobility, cognition, medication or carer-support information.
Clinical decision support only. A named clinician decides. Generated 12 Sept 2026, committed for the demonstration; wording adjusted to Cairn's language rules where the review used terms Cairn avoids.