We’ve drawn these three steps and four good practice points together with help from resources and colleagues from Care Quality Commission (CQC), Royal College of Nursing (RCN), Queen’s Nursing Institute (QNI), and Controlled Drug Accountable Officers (CDAOs). They are not intended to be prescriptive; organisations and health economies will need to set up systems to access end of life care (EoLC) medicines in a pandemic that work best in their localities.
Step 1: Use the business as usual supply route
Where possible the usual supply route should be used. The most common ways medicines are obtained in the out-of-hospital setting is via a community pharmacy or via a hospital pharmacy if the patient is being discharged home. Figure 1 below illustrates the usual process. Consideration also needs to be given to the supply of parenteral fluids as stakeholders have reported that accessing such items is also important in the care of the dying patient.
Step 2: Enhance the usual supply route to meet the needs of patients
Some commissioners have put in place enhanced services to ensure that community pharmacies within their locality hold agreed stocks of EoLC medicines.