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Are subcutaneous palliative medicines available and accessible: an out of hours (OOH) audit in sheffield
  1. Elizabeth Miller1,
  2. Julie D Morgan2,
  3. Alison Blenkinsopp2 and
  4. Christina Wong1
  1. 1Sheffield Teaching Hospitals NHS Foundation Trust, UK
  2. 2University of Bradford, UK


Introduction NICE quality standards (2011) state palliative care drugs should be fully accessible 24/7. National drug shortages, insufficient local stockholdings and prescriptions for items not on the recommended palliative list can make this problematic especially out of hours (OOH). There is little research on referral patterns for accessing subcutaneous medicines OOH.


  1. Determine if subcutaneous palliative medicines are fully available OOH Investigate whether supplies vary between hospital and community pharmaciesUnderstand referral patterns to access medication

Method A 12 month retrospective audit of GP OOH supplies from a hospital pharmacy with a prospective 4 week audit and carer survey in a large community pharmacy providing OOH supplies.

Results Locally derived standards from commissioned service set at 100% (n = 68 in GP OOH/hospital, n = 21 in community pharmacy).

100% of core subcutaneous medicines were available 24/7. Use of midazolam, diamorphine and hyoscine butylbromide similar across both settings; however levomepromazine was more common in the community following a national shortage of haloperidol. See table 1.

29% of community pharmacy issues were for formulations not on the recommended palliative list.

80% (4/5) patient referrals were made to the community pharmacy; 20% (1/5) going to more than one pharmacy.

Abstract 61 Table 1

Subcutaneous palliative care drug supplies

Conclusion Subcutaneous palliative care drugs are fully available in the OOH setting however further research should be undertaken to assess referral patterns.


  1. National Institute for Health and Care Excellence (NICE). Quality Standard 13 End of life care for adults. London: NICE; 2011

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