In many areas of the UK, informal and family carers are being offered training to give subcutaneous medications at the end of life, to support good symptom control for those dying at home. A variety of different programmes are used, in different geographical regions. Policies, consent forms, information leaflets, training competencies and documentation charts are usually in place. In Suffolk, we have developed a single booklet, containing all the paperwork both staff and families could need, for our FAM programme (Families Administering Medications). The writing of this was supported by an MDT and lay volunteers. Everything is written in a user-friendly style, and is all held together in one place. This ensures no part of the process gets missed or lost, and is instantly accessible to family and professionals at all times. Families document their administration of each medication in the same booklet as their training competencies are documented, for ease of repeated review of the administration process.
All booklets contain a family and staff feedback form with prepaid envelopes. Evaluation of feedback received has been very positive about the booklet, which is described as being very clear. Evaluation has also allowed real-time feedback about useful edits for version 2, which were able to be rapidly incorporated.
The process was initially agreed for the county of Suffolk, but presentation of the process to the newly-formed Suffolk and NE Essex ICB was very positively received, with NE Essex staff preferring the streamlined Suffolk booklet. This has led to vital collaboration, with the combination of the processes across the two areas, as a new ICB-wide process is agreed. The wider reach of the process will benefit patients and families (particularly those in border areas), and enable the pooling of resources for implementation of the process, to maximise those to whom it is made available.