Background Access to urgent end of life medications out of hours can be difficult at times (Ogi, Campling, Birtwistle, et al., 2021. BMJ Support Palliat Care.), so how could we work together to ensure vulnerable patients in the middle of a global pandemic get what they need when they need it most? How could hospices support patients and families if the worst should happen, and other community services were overstretched?
Aims To provide consistent 24-hour, 7 day a week access to palliative medicines and advice for patients and professionals alike (National Institute for Health and Care Excellence. [NG163]. 2020). To have plans in place to support carer administration of medicines (Poolman et al., 2020. CARer-Administration of as needed subcutaneous medication for common breakthrough symptoms in home-based dying people in Wales.) if services were overwhelmed and help support the predicted strain on the NHS.
Results Patients’ and health professionals were able to access 24-hour palliative care advice and a network of community pharmacies supported by the local Commissioning Support Unit (CSU) linked together to make finding and accessing medicines easier. Clinical Commissioning Group (CCG) pharmacists provided delivery services to those who were vulnerable, shielding or just needed help. Hospice teams worked together to provide cover, other professions utilised this support too, calls from paramedics resulted in patients staying at home rather than being transferred to hospital. A local NHS Trust provided back up supplies to enable around the clock dispensing in urgent circumstances.
Conclusion Only by working collaboratively across the area and sectors were we able to provide a safety net. The pandemic removed some of the financial and organisational barriers to make this happen. Some of this work is now established and continues. Other aspects have highlighted an ongoing need for future commissioning and improved patient and care giver experience (Wilson, Caswell, Turner et al., 2018. J Pain Symptom Manage. 56:962).
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