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49 A UK-wide service evaluation of documents relating to anticipatory prescribing at the end of life
  1. Richella Ryan,
  2. Anna Spathis,
  3. Ben Bowers and
  4. Stephen Barclay
  1. University of Cambridge


Background Anticipatory Prescribing (AP), or ‘Just in Case’ prescribing ahead of need, is a well-established component of end of life care in the UK. It aims to facilitate effective symptom control in the home and care home setting and reduce crisis hospital admissions near the end of life. However, it is a complex multi-system process with great potential for variation and error. The aim of this study is to investigate the role of local policies and procedures in guiding AP practice in community end of life care across the UK.

Methods The first (England) phase of a UK-wide service evaluation has sampled 55 CCGs in England, stratified by NHS local office region, size and level of urbanisation. A range of stakeholders (senior doctors, nurses, pharmacists or CCG managers) were contacted by email and asked to identify and supply the documents used in their areas to regulate and facilitate AP.

Results Responses obtained to date are from 29 of 55 CCG areas in England (53%). Whilst all areas have some form of generic prescribing guidance, only 11/29 (38%) have specific AP policies, 10/27 (37%) have AP-related patient information leaflets and 4/27 (15%) have AP standard operating procedures.

Conclusion Despite the complexity of the AP process, there is limited formal documentation of standard procedures and professional responsibilities in many areas, with considerable variation in type and level of regulation. Data collection is continuing and will be extended to all four UK countires, with qualitative analysis of responses and documents supplied planned.

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