End of Life Care- updated guidelines and paperwork

Date sent: Monday 14 May 2018

Dear %recipient.firstname%,

End of Life Care- updated guidelines and paperwork

Identifying patients who are End of Life, and providing anticipatory medications for symptom management, are important roles for general practice. The LMC has been working with St Barnabas Hospice, MacMillan nursing, Marie Curie, and other organisations to develop new prescribing guidelines for patients who are in the End of Life period.

These new guidelines are being published on 14th May 2018, and and are attached to this email.

The guidelines make some changes to what has previously been common practice, the most important of these is:

Morphine (not diamorphine) is now listed as first line choice of analgesia for prn and syringe driver use, as there have been supply availability issues with diamorphine
Alfentanyl is now listed for use in patients with severe renal disease

Accompanying the new guidelines is a new CD1 form, which incorporates the guideline changes. The new CD1 form can be used from 14th May 2018, though the old one does not need to be replaced for patients who have already had anticipatory drugs prescribed. The new CD1 form is attached in Word format to be integrated onto clinical systems.

A palliative care formulary, for integration with SystemOne and EMIS will also be made available, for ease of prescribing.

The new guidelines and CD1 form are also available on the LMC website.

Please share this information with your clinical teams.

Best wishes

Kieran