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107 A service evaluation of a new policy to support carers giving subcutaneous anticipatory medications at home at end of life within Southern Derbyshire, population of 607,000
  1. Mary Lewis,
  2. Jonjo Heneghan and
  3. Joseph Burdon
  1. Nightingale Macmillan Unit, Royal Derby Hospital


Background The Derbyshire Policy for Informal Carers Administration of as required Subcutaneous Injections in Community Palliative Care was developed by Specialist Palliative Care Services, in conjunction with multiple agencies across Derbyshire. During policy development, for governance and learning, it was agreed that a rolling service evaluation would be undertaken and learning fed back to community partners annually.

Methods A qualitative acceptability question was posed to the caregiver after the relative had died. ‘Was the process acceptable and beneficial?’

Demographic and quantitative data was collected at time of death.

  • Number of injections of each drug given was collated from stock balance charts in the patient‘s home and correlated with the call log.

  • Number of days carer enabled to give anticipatory drugs.

All carers were trained by the same palliative care consultant and supported by a designated community palliative care nurse. To support carers, a telephone call to specialist palliative care was mandated prior to each injection being given by the carer.

Results Six carers were trained between March and September 2020. Five have a health professional background. Four were trained at home and two in the Specialist Palliative Care Unit. Qualitative data is available for four patients who have died. The number of injections of anticipatory medications given by carers varies.

Patient 1: 109 injections over a 137 day period of care

Patient 2: 9 injections over a 7 day period of care

Patient 3: 2 injections over a 6 day period of care

Patient 4: 41 injections over a 16 day period of care

The breakdown of which drugs were given is available. All 4 relatives of deceased patients felt that the training was acceptable.

Conclusions Training carers to give subcutaneous anticipatory medications at home is acceptable and enables drug administration. The policy is available at

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