Call to embed community pharmacists in multidisciplinary palliative care teams

Community pharmacists must be embedded in multidisciplinary palliative care teams in rural communities and have access to shared care plans and health records, a new report by Hospice UK has urged.

The report, called Bringing care closer to home: Improving palliative care in remote, rural and island communities, has highlighted the critical role of community pharmacists in providing palliative care in remote, rural and island communities, while calling for urgent systemic improvements and additional support.

Drawing on surveys with patients and healthcare professionals, Hospice UK warns there are significant challenges within rural communities in accessing medication and pain relief.

Families often endure lengthy journeys, sometimes visiting multiple pharmacies, to find essential medicines, the report noted.

In addition, family members frequently report anxiety about administering medication without proper training or guidance, with some emergency medication boxes (‘just in case’ boxes) found to be inadequately stocked.

The charity described community pharmacists as integral not only in dispensing medication but also as key advisors within their local communities, but recognised the increasing pressures and financial constraints they face.

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According to the report, an escalating number of pharmacy closures in rural areas has also severely impacted community health support.

Hospice UK outlines several recommendations to address these challenges, advocating for a ‘national standard’ in community pharmacy palliative care services.

This would 'help make services more consistent and make it clearer what patients, families and other professionals can expect'.

The report stresses the importance of closer collaboration between hospice care providers, GPs, community nursing teams, community pharmacists, social care staff and out-of-hours teams.

In addition, the report recommends embedding pharmacists within multidisciplinary palliative care teams, granting them direct access to shared care plans and patient records and to training in palliative care and bereavement support.

Establishing a designated palliative care specialist pharmacist within each local health system ‘would help assist with training and advice’ for community pharmacists, according to Hospice UK.

The report also emphasises the need for enhanced education and training for rural pharmacists, advocating the use of structured frameworks such as the Marie Curie and Royal Pharmaceutical Society’s Daffodil Standards for Community Pharmacy.

Additionally, it identifies electronic prescribing as a vital step in streamlining medication access, reducing delays and minimising travel needs.

Implementing locally funded delivery services and establishing simple, accessible systems for patients, carers and healthcare professionals to easily check pharmacy stock are further key suggestions, along with dedicated support to help rural pharmacies extend their opening hours, particularly during weekends and evenings.

The report concludes: 'Creative, flexible approaches, rooted in local knowledge, can start to drive meaningful change. At the same time, we need long-term, strategic action.’

It adds: ‘National and local policies must prioritise rural communities, ensuring the workforce, funding and infrastructure are in place to meet the growing demand for high-quality, community-based palliative care.'

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Commenting on the report, Dr Leyla Hannbeck, chief executive of the Independent Pharmacies Association (IPA) said: ‘Hospices and pharmacies offer the best of community care, and it only makes sense that we work closer together – something I am keen to ensure happens.

‘But the fact remains that community pharmacy, especially in rural areas, is under enormous stress at present.

‘We stand ready to do more, but without the investment required, we are not going to be able to do our part to support the government’s plans to bring care closer to home.’

She added that as the government develops its plan to reform the NHS and as the sector faced contract renewal in the autumn, community pharmacy ‘should be invested in and empowered to support community care and local hospices’.

Royal Pharmaceutical Society (RPS) policy lead in Wales, Alwyn Fortune, added: ‘Community pharmacies are a vital lifeline for medicines and for compassionate, expert support at this most difficult time in people’s lives.

‘Yet too often, patients, families and carers face delays and problems in getting the support they need from across the healthcare system, especially in rural and remote communities.’

Mr Fortune, who is leading a refresh of an RPS palliative care policy which will be published later this year, agreed with the report’s recommendations on embedding pharmacists within multidisciplinary teams.

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‘We want to see governments and the NHS embed pharmacists within multidisciplinary teams providing palliative and end of life care and provide them with read-write access to patient records,’ he said.

‘Investing in pharmacies so they have the training and resources needed to build on the delivery of high-quality, accessible care is central to this.’

And he stressed the need for a ‘coordinated, well-funded approach to ensure no patient or carer is left without the help they deserve’.