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.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).Results
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.Results
29% of community pharmacy issues were for formulations not on the recommended palliative list.Results
80% (4/5) patient referrals were made to the community pharmacy; 20% (1/5) going to more than one pharmacy.Conclusion
Subcutaneous palliative care drugs are fully available in the OOH setting however further research should be undertaken to assess referral patterns.