Supporting rural communities with palliative care

gill harrington

Gill Harrington MRPharmS, Palliative Care Community Pharmacist from Strome Ferry, near Skye.

In 2012, NHS Highland set out to explore a new service model piloting the development of a full-time Macmillan Rural Palliative Care Pharmacist Practitioner. The aims were to develop community pharmacy to support the needs of palliative patients, improve service provision, develop training and peer support opportunities and provide quality information to support practice. I was appointed in February 2013 and have been on a steep learning curve to enhance my knowledge of palliative care issues, along with defining areas for development within the project.

Within these areas were a series of training resources, “Sunny Sessions” for Care Home Staff, which I have delivered to all the care homes in the locality. We are hoping to roll these out to care at home and informal carers in the near future. We have also produced mousemats and mugs containing palliative care prescribing information for healthcare professionals which have proved very popular as they are easily accessed when the information is needed.

Palliative care prescribing information for healthcare professional made easily accessible on mugs and mousemats
Palliative care prescribing information made easily accessible on mugs and mousemats.

I have been attending multidisciplinary and gold standard review meetings at local surgeries and have been able to feed back relevant information to the local community pharmacies. We have now been able to access IDL (immediate discharge letter) information for the local pharmacists which greatly helps hospital discharges.

I have set up an online group of local GPs, nurses and pharmacists who I send any palliative care related news such as supply issues and medicine updates. I am involved in deciding treatment options and formulations for patients and am able to visit patients at home or see them in the surgery or the community pharmacy if they have any queries regarding their medications. I have also set up clinics with two practices were I see (and prescribe for) patients with palliative or chronic pain. Along with working within a community pharmacy this enables me to have a truly holistic view of my palliative care patients.

For NHS Scotland, the evidence from this project presents a clinical practice model for community pharmacy palliative care services in rural areas in line with Prescription for Excellence. The project is due to finish in February 2016, but we are hopeful that funding will be made available to roll this model out to other areas. I am hopeful that my experience will create more opportunities for community pharmacy to become more involved in providing palliative care locally.

The Palliative Care Partnership between Boots, Macmillan and NHS Highland has been put forward to Scottish Government as part of a motion by MSP Rhoda Grant. The motion has achieved cross-party support and should lead to a debate later in the year.

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