Palliative Care: Care when you need it most

This fortnight I am on call as the Palliative Care pharmacist for Lothian. When we signed up to the scheme last year, I wasn't quite sure what to expect. We attended a training session covering which drugs can go into syringe drivers together, what doses of painkillers are comparable and the logistics of the scheme. We agreed to stock a core list of drugs used in palliative care and also signed up to be on call on a rota with eight other pharmacies.

The aims of the palliative care network in Lothian are to:

• Allow timely access to palliative care drugs for patients being cared for at home
• Provide quality information regarding palliative care drugs to patients, carers and other health care professionals
• Support and maintain a network of "palliative care" community pharmacies in NHS Lothian and liaise with other health care professionals on palliative care issues to ensure ongoing excellence.

The Scottish Government produced a forward thinking paper a number of years ago - Living and Dying Well which has prompted a huge amount of good work for patients with conditions which cannot be cured. Much of the work is around anticipating what a person may need and planning their care. In Lothian we are fortunate enough to have two fantastic hospices, Marie Curie and St Columba's. Their teams work across primary and secondary care and with all sectors to give patients and their families the best quality of life for however long that may be. It is an excellent example of great communication and a commitment to deliver top quality care.

The network of pharmacies in Lothian, I think, was the first in Scotland and is now a well used model across the country. Each call out has been different. One has needed my specialist knowledge, one merely a signposting exercise to another pharmacy on a Saturday evening, and the last was to provide a package of drugs used to treat the symptoms which come on in the last days of life. Each of those call outs has hopefully made a difference to those patients and their familes at a time when there are so many other things to worry about. Getting access to the right medicines at the right time should not be one of those things. I feel very proud to be part of this network and will continue to try to help my patients have a good death.

The Scottish Partnership for Palliative Care is an umbrella and representative organisation which, through a collaborative approach, supports and contributes to the development and strategic direction of palliative care in Scotland. Its objective is to promote equitable access throughout Scotland to high quality palliative care for all patients and families on the basis of need not diagnosis. There website is well worth a visit.