Introduction: Digital approaches to support the recording and sharing of advance care plans (ACPs) are being increasingly used globally. Little is known about how patients engage with digital ACPs. 

Aim: To explore patient and carer views of a national approach to digital advance care planning used in the UK; Electronic Palliative Care Coordination Systems (EPaCCS). 

Methods: An online survey was undertaken in partnership with Compassion in Dying, a UK-based national patient and public advocacy organisation. Participants were asked to rate their level of confidence that health professionals (HPs) would access their digital ACPs as well as how potential features might increase confidence. Free-text items captured information about views and experiences. Descriptive statistics were used to analyse ratings and thematic analysis was used to analyse text.

Results: A total of 1,728 responses were received, representing all geographical regions of the UK. Respondents included people with a terminal condition, with a long-term condition, carers, and those interested in planning for the future. Median ratings across all respondent groups indicated a low to moderate level of confidence that health professionals would access their digital ACP. The ability to view their own plans, record and update care preferences, and share their care plans with family and loved ones were deemed likely to increase confidence. Quality discussions with health professionals can increase confidence in wishes and preferences being followed. Negative experiences often related to HPs' lack of engagement with documentation and viewing ACPs.

Conclusions: People value ACP processes, and are motivated to ensure their wishes and preferences are shared. EPaCCS may not be supporting sharing of ACPs as intended, with widespread apprehension about HP engagement. Further research to explore processes for building trust is required. Trust could be fostered via patient access to their record and the ability to confirm HP's use of it.