Formulary


	NHS Bath and North East Somerset, Swindon and Wiltshire CCG Royal United Hospitals Bath NHS Foundation Trust Great Western Hospitals NHS Foundation Trust Salisbury NHS Foundation Trust

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Formulary Chapter 21: Palliative Care Formulary - Full Chapter

Notes:

APRIL 2020 BSW End of life COVID palliative care guidance EOL COVID prescription support v5 Note this contains options that may be suitable to use in EoL patients with swallowing difficulties and where syringe drivers may be unavailable.

NICE NG163 - COVID-19 rapid guideline: managing symptoms (including at the end of life) in the community

The Wessex Palliative Care handbook contains guidance to help GPs, community nurses and hospital staff as well as specialist palliative care teams. It aims to provide a checklist for the management of common problems in palliative care, with some information on drug treatment. It is not a comprehensive textbook. The Palliative Care Handbook: A Good Practice Guide Wessex Palliative Physicians Ninth Edition 2019

For contact details of hospices and emergency drug lists and pharmacies participating across Bath, Swindon and Wiltshire scroll to bottom of chapter or click here Community Pharmacy Emergency Drugs List & Contact Details

Details...

21.04

Just In Case Prescribing by Secondary Care

‘Just in case’ (JIC) medication for patients transferring out of the RUH

The Specialist Palliative Care Team in the RUH are keen to improve the quality of transfer of patients who wish to die in their own home or nursing home. Part of this is to ensure that patients have access to ‘just in case’ (JIC) medication if needed soon after leaving hospital. There are clear procedures in place in the community for this, but it is best practice for the staff most recently involved in the care to take responsibility for ensuring the following is in place:

The patient wishes to be at home
It is anticipated that they may deteriorate quickly and do not already have JIC medication in their home or nursing home
Medication supplied in a pack with syringes and needles and a prescription / administration form signed by the hospital doctor that is valid for up to 7 days for community staff – this will allow medication to be given if needed prior to the community procedure being put in place
Morphine supplied for JIC and in syringe driver if in place on transfer

For patients who are transferring home for care towards the end of life, but are not anticipated to deteriorate quickly, it is suggested that the community follow their own procedure for JIC medication. If anyone has any concerns, wants further information or wishes to provide feedback please contact: RUH Specialist Palliative Care Team, 01225 825567. For documents relating specifically to RUH Just In Case follow link

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Key

	Notes
	Section Title (top level)
	Section Title (sub level)
	First Choice item
	Non Formulary section
	Restricted Drug
	Unlicensed
	Display tracking information
	Link to adult BNF
	Link to SPCs
	Scottish Medicines Consortium

	Cytotoxic Drug
	Controlled Drug
	High Cost Medicine
	Cancer Drugs Fund
	NHS England
	Homecare
	CCG
	High Cost Drug Approval System

Traffic Light Status Information

Status	Description
	RED - Hospital only – to be prescribed by a specialist and supplied from secondary care ONLY throughout treatment.
	Amber medicines are considered suitable for GP prescribing following specialist initiation or recommendation.
	Shared Care - these medicines require specialist initiation and stabilisation. Ongoing division of responsibility for drug and disease monitoring between specialist and GP by a Shared Care Guideline (SCG). If no SCG in place status reverts to red.
	These medicines are appropriate for initiation in both primary and secondary care. Prescribing is appropriate within licensed or local recommendations.
	Suitable for patient to be directed to buy themselves
	Not currently used. We intend to include this TLS in future to highlight where a decision to use this medicine is under review.
	Not currently used. We intend to include this TLS in future to highlight where a decision has been made by either or both the local or national NHS not to routinely commission this preparation for its licensed indications. Do not prescribe.
	Not currently used. We intend to include this TLS in future to highlight where this medicine and indication is ONLY available through a Specialist Centre according to a NICE Highly Specialised Technology or NHSE Specialised Commission Circular / Policy.