Palliative Care / EOL:
Each LPC geography has pharmacies signed up to support the provision of end of life (EOL) medicines and a list is available from the CCGs and on the LPC websites. You may also have heard about the possible increase in requirements due to Covid19 in hospices and care homes. If stock shortages occur with some key lines some care homes may have held back some stock to be reused. This will only come into play should a specific item or alternative be unavailable within timeframe needed. If you receive a prescription for EOL and cannot fill it within timeframe required you should contact one or more of the pharmacies holding stock as part of the CCG service to try and meet the requirements. Failing this, alternatives in stock should be suggested. If still some items outstanding you need to contact the home / hospice and check if they have a medicine reuse scheme in place and share a copy of the prescription as per guidance.
1. Where there is no available stock (Community Pharmacy contacted during opening hours) and a prescription cannot be written for the alternative medicine (e.g. out of hours or no alternative available), the community pharmacy team with responsibility for the prescription should ask the care home or hospice whether they run a medicines re-use scheme and whether they have any stock of the required medicine.
2. If stock of a re-used medicine is available in the care home or hospice, the community pharmacy team must share a copy of the prescription for that medicine with the home, this may be done by email or physical collection or delivery of the prescription. The supply of the medicine by the care home or hospice will need to be in accordance with that prescription. They cannot rely on a report of its contents.
3. Where possible the pharmacy should provide a new corresponding MAR chart, as necessary. If it is not possible to provide a new MAR sheet, and the patient resides in a residential home where there are no registered healthcare professionals on site, the registered healthcare professional authorising re-use should ensure that the MAR chart has been updated correctly, this may be done virtually.
In order to manage additional demand for end of life medicines, and ensure safe, equitable and compassionate care for patients, we have worked with the Association of Palliative Medicines, Royal College of GPs, Hospice UK and the Association of Supportive and Palliative Care Pharmacy to publish Priority medicines for palliative and end of life care during a pandemic. This clinical guidance for essential end of life medicines, which sets out the first and second choices for these medicines, will enable the NHS to conserve supplies, switch to alternative drugs when required and minimise
waste. This is also being used to guide the purchasing of medicines for the UK. It aims to support healthcare professionals working in palliative and end of life care, including GPs and pharmacists, across hospital, community, social care and hospice settings to work together in managing additional demand for end of life medicines due to COVID-19. This should be read alongside the recently published DHSC standard operating procedure on how to run a safe and effective medicines reuse scheme in a care home or hospice during the coronavirus outbreak.