Cellma: Smarter Digital Support for Community Care Services

As per NHS Community Services Statistics report, England recorded 1.73 million community care referrals in September 2024 alone.  Of these, 320,565 referrals were for children and young people, 504,370 referrals were for adults aged 19 to 64, and 905,660 were for adults aged 65 and over. These numbers are not simply numbers they represent real people, complicated needs, and the ongoing pressure on community care services to be more responsive, safer, and closer to people’s homes. 
 
As the UK health system shifts focus from reactive to proactive care, community teams play a vital role in keeping people out of hospital, supporting early discharge, and managing long-term conditions in the most appropriate setting: the community. 
 
But to make this work, professionals on the ground – district nurses, allied health professionals (AHPs), mental health teams, reablement and rapid response units need fast, mobile, and reliable access to patient information and clinical tools. And this is where Cellma, a best-in-class AI powered EHR, comes into play. 

What Is Community Care Services? 

Community care services refer to the wide range of health and social care provided outside of the hospital setting. Community care is typically the first line of response to vulnerable, older, and chronically ill patients.  
 
Some of the key services that the Community Care team of professionals’ offer are: 
 
District Nursing: Providing wound care, administering medications, palliative care, catheter management and chronic disease monitoring in a patient’s home. 
 
Allied Health Professionals (AHPs): Including physiotherapists, occupational therapists, speech and language therapists, and dietitians that support rehabilitation and function. 
 
Community Mental Health Teams: Providing psychiatric assessments, care coordination, crisis support, and long-term mental health management. 
 
Health Visiting and Child Health: Supporting early intervention, safeguarding, and parental support. 
 
Reablement: Helping people to regain their independence after illness or discharge from a hospital. 
 
Palliative and End-of-Life Care: Addressing compassionate end-of-life care and pain management at home. 
 
Rapid Response and Unscheduled Care: Providing urgent interventions to prevent avoidable hospital admissions. 
 
These services play a pivotal role in providing timely, local, and personable care, but many are held back by disjointed systems and paper-based processes.  

Clinical Conditions Managed in Community Care – Supported by Cellma 

Community care teams work with a range of clients – from post-acute rehabilitation to end-of-life care. Cellma is meant to help clinically connect and enhance the care of various conditions:  

Chronic Disease Management (e.g., Diabetes, COPD, Heart Failure)  

• Monitor vital signs, blood glucose, spirometry, and weight trends using condition-specific templates.  

• Tailored alerts and pathways for routine monitoring, escalation, and referrals.  

• Patient education and care planning is part of each contact; documentation of shared goals. 

Dementia and Cognitive Impairment  

• Integrated cognitive assessments (e.g., MMSE, MoCA) and mental health assessment tools or structured assessment templates.  

• Care plans modified to focus on carer support, risk management, and social interventions.  

• Visibility across providers ensures coordinated dementia reviews and medication monitoring.
  
  

Wound and Pressure Ulcer Management 

• Photograph wounds securely, track healing over time, and apply standardised documentation protocols (e.g., TIME framework). 

• Custom alerts for deterioration or overdue dressing changes. 

• Seamless communication with tissue viability teams and community matrons

Respiratory Conditions (e.g., Asthma, COPD Exacerbations)

• Templates include peak flow diaries, inhaler technique assessments, and oxygen saturation tracking. 

• Integration with lab results (e.g., CBC, CRP, blood gases) and imaging. 

• Clear care pathways for home-based nebuliser therapy or escalation.
   

Mental Health in the Community

• Incorporates risk assessments, psychologically validated tools (PHQ-9, GAD-7, HoNOS), and crisis planning. 

• Multidisciplinary entries, joint care planning with CMHTs, and shared safeguarding records. 

• Custom flags for safeguarding, domestic violence, and substance misuse.
  
  

Palliative and End-of-Life Care

• Integrated documentation, anticipatory prescribing, and symptom tracking. 

• Shared care plans visible to all involved providers including hospice, GPs, and out-of-hours services. 

• Holistic templates for pain, breathlessness, and spiritual needs.
  
  

Falls, Frailty and Mobility

• Frailty index calculators, falls risk assessments, and physiotherapy outcome measures built in. 

• Rehab goal tracking and community equipment prescriptions. 

• Support for multidisciplinary reviews and onward referrals (e.g., to Falls Clinics or Home Adaptation Teams).

• Each of these conditions is managed within secure, structured clinical templates that allow standardisation while allowing local flexibility. 
  
  

Cellma: Built for the Realities of Community Care

Cellma is a smart, AI-driven Electronic Health Record (EHR) that is built to suit the realities of community care services. Whether you’re coordinating a discharge, working with a frail patient in their home or in a rapid response environment, Cellma places the right information at your fingertips at the right time. 

Cellma gives community teams the digital toolkit they need to work efficiently and collaboratively; anywhere, anytime. Here’s how:

• Customised Assessments & Clinical Tools: Cellma offers a library of customisable assessments, clinical calculators, and templates, all tailored to your service model. Quickly document home visits, triage assessments, or wound care reviews in real-time.

• Dynamic Care Plans and Pathways: Create, manage, and update personalised care plans and clinical pathways that reflect local protocols. Real-time updates allow multidisciplinary teams to collaborate smoothly.

• Integrated Referral and Patient Portals: Cellma’s Referral Portal enables fast, structured referrals between services. The Patient Portal ensures patients and carers are informed and engaged in their care journey.  

• Integrated Diagnostics: Cellma integrates with PACS imaging and lab information systems, ensuring diagnostics are accessible on the go – no delays, no duplication. 

• Modular and Role-Based: Cellma’s interface adapts based on each user’s role – nurses, therapists, coordinators, or managers. Whether it’s a rapid response or a routine visit, users only see what’s relevant to them.  

• BI Reporting and Insights: Built-in Power BI dashboards help managers monitor KPIs, track outcomes, and plan services more effectively.

Seamless Integrations to NHS 

Cellma’s integrations with national systems across the UK means they can provide continuity and accuracy, including:

• PHS & Data Intelligence 

• CHI (Community Health Index) 

• GP Connect 

• ECS (Emergency Care Summary) 

• SCI Gateway  
  
  

These integration capabilities provide clinicians with a single, up-to-date view of a patient’s health record (wherever the care is being delivered). 

Security and Compliance You Can Depend On 

With Cellma you get data security and functionality with peace of mind.

• End-to-end encryption 

• CIS2 compliant access 

• NHS PDS integrated 

• GDPR and Cyber Essentials Plus compliance 

• Hosted in NHS-compliant ISO 27001 certified environments 

• Compliance with national datasets; ECDS, NCCMDS and WECDS, etc.  
  
  

So, everything is safe, secure and compliant from day one with Cellma. 

Intelligent Analytics Included 

Cellma is equipped with robust tools like Power BI for monitoring referrals and outcomes, monitoring service demand, enabling providers to enhance care at all levels.  

ICD-11 and SNOMED CT are fully integrated into Cellma, using consistent coding for all clinical data reporting to support effective decision making within community care services. 

Empowering the Teams Who Deliver 

For busy district nurses, Cellma means you won’t be chasing paper records, and you won’t need to rely on memory. You will have access to everything you need; patient history, medications and plans for wound care – where and when you want them. 

For AHPs, it supports goal tracking, rehab pathways, and multi-disciplinary collaboration. For community mental health teams, it provides secure, structured documentation and safe handovers with secondary care. 

And for the entire system, Cellma helps reduce duplication, support proactive care, and enable better outcomes for patients – right where they live. 

Artificial Intelligence to Support Better Community Care 

Cellma, our leading-edge EHR is an innovative partner in offering safer, smarter community care services. With built-in artificial intelligence, Cellma can take everyday workflows to a whole new level. 

With Natural Language Processing (NLP), clinicians can quickly identify key clinical information from unstructured notes and patient histories. This is equally invaluable for a district nurse finishing off previous assessments, or a rapid response team needing to make decisions at speed, both can extract key clinical information in seconds and make informed decisions faster and accurately. 

Cellma also has real time alerts for drug interactions. By making sense of a patient’s care history in Cellma, it can spot possible medication risks and emerge alerts for a clinician before a harmful combination of medication occurs. 

These combined features, provide ‘smart’ care that is provided at home, in the community, and during emergencies – to ensure that the care given is informed by the best patient data and the right care is delivered safely and accurately. 

Cellma is more than an EHR. It’s a full ecosystem for community care services – smart, compliant, and ready to support every patient journey. 

Whether you’re delivering post-discharge rehab, end-of-life support, or rapid interventions in the field, Cellma keeps care connected.