Royal Cornwall Hospital

Truro

Cornwall TR1 3LJ

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© 2023 by Acute GP Service, CPFT. 

Symptom Control Packs

Packs for symptom control at the end of life have been brought together by palliative care teams 

and RCHT Pharmacy, and are in keeping with national guidance from the APM (Association of Palliative Medicine).

 

Procedure for the Requisitioning and Supply of COVID-19

Symptom Control Packs by GPs for Use in Patients’ Homes. V3 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Aims of pack provision

-To support the GPs / clinicians in providing compassionate and timely care to COVID-19 patients in their homes

-These packs are to be used following a clinical assessment of the patient by the GP and supplied to patients that are actively dying, not ‘just in case’

To  negotiate  CD  regulations  and  potential  safety  issues  they  are   not  "just in case" but  for  people who are symptomatically  at end  of  life  for  clinicians  to  take  in  with  them and  leave.  Patients and  carers  will  be  talked  through  what  for  and  what  not  ...and will  contain  an  aide  memoir of  the  reason  each  med  in  Pack. Carers will also  need  to  know  about  safe  disposal  of  partially used  or  un-used packs.

 

For  many  reasons  RCHT would  like to  issue  centrally  and  will  keep  on  a  shelf  50  or so  that they  can  be  ordered with  24  hr  turn  around  further stock.

 

They  will  need  to  be  stored  in  a  PCN as per CD rules and regs  and  distributed  as PCN  sees  fit among it's practices.

 

They  will  need  to  be  prescribed  by  clinician on  an FP 10  -  so  those  with  systems  that  allow  may  want  to  make  a template   etc.

KCCG (Dr Rob White is leading with Paul Abrams at KCCG) needs the lead practice name for each PCN where such packs can be stored and distributed from, with courier network distribution and signed for with email to acknowledge receipt.

Initial  roll  out  will  be 10  packs  per 10,000 PCN  patients, but with ability to restock through RCHT pharmacy.  Cost will be £32 per pack.

There will be information within the packs for carers about administration, which should support your consultation briefing about symptom control.

They  contain :-

 

  • Lorazepam 1mg tab S/L 1hrly/prn (max 4mg daily) for shortness of breath or  agitation  (supply – 14 tablets)

  • Levomepromazine 6mg tablet 2 hrly/prn for nausea (max 24mg daily) , vomiting or agitation (supply 12 tablets)

  • Hyoscine hydrobromide 1.5mg patch – 1 patch every 72 hours  to decrease lung secretions (supply 1 patch)

  • Fentanyl patch 12.5mcg- 1 patch

  • Paracetamol 500mg Tabs x20 prn

  • Oramorph 10mg/5ml 25ml- 2.5mg prn