Background The implications of the drug driving guidance on our specialist palliative care unit is unknown. We make assumptions that patients don’t drive a vehicle. It’s not a routine question on admission or something that is addressed whilst inpatient medication changes are being made and also not something discussed when a patient is discharged.

Methods A snapshot assessment of the 18 patients admitted to the inpatient specialist palliative care unit was performed on 1st October 2019. Patients were subsequently asked about driving, where appropriate, and the junior medical team provided education on the national drug driving guidance.

Results All 18 patients:

• Had prescriptions of medications listed in the drug driving guidance

• There was no knowledge or documentation of whether a patient was a vehicle driver

5 patients admitted for end of life care were therefore excluded from further analysis. When the 13 patients were asked:

• 10 patients were not vehicle drivers

• 3 patients were vehicle drivers

The drug driving guidance was discussed within the department’s service improvement meeting. An addendum on the clerking proforma was made to include whether the patient was a vehicle driver or not. If a patient was a vehicle driver it was highlighted on the joint MDT handover list, and if prescribed medication listed in the drug driving guidance, they were counselled on this. This was also communicated on the discharge summary for ongoing continuity of care.

Conclusion This project enabled joint collaborative work between doctors and the pharmacy team. It also highlighted the importance of not making assumptions about palliative care patients not driving a vehicle. Discussing the drug driving guidance with the medical team ensured that a patient was aware of the government guidance and ensuring public safety. A re-audit is planned in 2020 to ensure that this change in practice remains embedded.