Quality Improvement (‘Daffodil’) Standards for Palliative and End of Life Care

Published: 13/10/23

We are consulting on new standards on palliative and end-of-life care for community pharmacy. The consultation will be open for a four-week period from November 1 – December 1 2022.

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Consultation responses can be completed electronically here or in Word format below. If using Word format, please send consultation responses to daffodilstandards@rpharms.com.

All consultation questions are listed at the end of this document (p8).

Contents

• Community Pharmacy & Palliative Care

• Developing the draft standards

• Putting the standards into practice

• The draft standards

The Royal Pharmaceutical Society has teamed up end-of- life charity, Marie Curie, to launch a partnership to develop professional standards in palliative and end-of-life care for community pharmacy.

The Standards will be available for pharmacy teams across the whole of the UK and will provide a free, evidence-based framework to help community pharmacies self-assess and continuously improve their palliative, end-of-life and bereavement care for patients and carers.

They will enable community pharmacy teams to work together to develop their practice. These standards will align with the established Royal College of General Practitioners (RCGP) and Marie Curie ‘Daffodil Standards for advanced serious illness and end of life care’ for GP Practices.

Community Pharmacy & Palliative Care

People living with life-limiting conditions and palliative care needs will have some basic expectations and having timely access to medicines and clinical support from a skilled pharmacy team are amongst them.

This support may involve providing information about any new medicines started to help manage symptoms, and an explanation and reassurance about medicines that are stopped (where the benefit: risk balance suggests that it is the best thing to do).

Other key contributions that Community Pharmacy can make in palliative or end-of-life care include:

• advice on administration of medicines should swallowing become a problem e.g. availability of liquid formulations, patches;

• dealing with medicines supply chain issues where they arise;

• helping with monitoring the wellbeing of the patient and their carer(s) through their regular contact and accessibility;

• helping with signposting to the right support to meet the needs of the patient or their carer(s), by working with the local multi-disciplinary team.

Developing the draft standards

The current draft standards are based on evidence and the views and experience of those who are involved in community pharmacy and palliative and end-of-life care.

To complement a robust review of existing UK and international evidence and literature on the subject, the main source of expertise that have informed the standards to date has been a steering group consisting of community pharmacy experts, and other healthcare professionals with expertise in palliative and end-of-life care.

Regular input and advice has also been provided by the RPS Community Pharmacy Expert Advisory Group. Input has also been sought by those who have experienced palliative and end-of-life care from a patient/family perspective, as well as other relevant stakeholders with a community pharmacy and/or palliative or end-of-life care remit.

Putting the standards into practice

The draft standards cover eight core areas (see below). The community pharmacy will deliver the eight standards through a range of activities, as summarised in the table below. The standards are a focus for quality improvement and reflect good practice in palliative and end-of-life care delivery, with a medicines management focus. There is no formal accreditation process but a self-assessment and continuous quality improvement approach.

The standards reflect good practice and can be applied to a whole population affected by palliative and end-of-life care and bereavement, or a pharmacy can choose to focus on a particular standard of interest or a cohort of people.

It is recognised that the standards should not be too onerous for community pharmacy to achieve, and evidence gathered can be used for multiple purposes (E.g continuing professional development or inspections).

The standards should also be inclusive and available for us by everyone working within community pharmacy, including individual locum pharmacists. Therefore, the final published standards will be available for individuals to ‘sign up’ and complete those standards that can be met by an individual locum pharmacists (see column in the table).

Supporting to put standards into practice

The final published standards will be accompanied by a range of supportive materials, similar to the resources supplied as part of the RCGP standards.

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