Royal Pharmaceutical Society

Palliative and end of life care in community pharmacy

by Darrel Baker, Chair of the Daffodil Standards steering group

We’re working in partnership with end-of-life charity Marie Curie UK to develop quality improvement standards in palliative and end of life care for community pharmacy.

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

For most societies, death is a community concern; poorer nations with limited access to healthcare services have little choice other than making death a community matter. This has long been part of human social evolution: caring for the aged and dying, assisting carers, and supporting those who are suffering loss and bereavement. Such hands-on care is performed by people in the community, sometimes in partnership with professional carers.

Since the mid-’90s, interest has been increasing in public health approaches to end-of-life care following the development of the principles of ‘health promoting palliative care’. Most of us working in palliative care would like to see an end to the stigma and taboo around death, allowing people to prepare well for death, and ensuring that they are supported during grief and loss in their community, with access to services appropriate to their individual needs.

What is a “compassionate community”?

A “compassionate community” is an umbrella concept encompassing a wide diversity of practices and rooted in a health promotion approach to palliative and end-of-life care.

A compassionate community recognises that care for one another at times of crisis and loss is everyone's responsibility, and not a task solely for health and social services. Compassionate communities encourage, facilitate, support and celebrate care for one another during life's most testing moments.

When used in the field of public health palliative care, the term “compassionate community” is not only about the attributes of the community, but also the methods used to create such communities. In recent decades, hundreds of compassionate communities have been established around the world, demonstrating an international willingness towards community-led models of social and practical support for people living with advanced illness and their caregivers.

Compassionate community initiatives can be built wherever there are people: in schools, workplaces, trade union movements, hospices, care homes, neighbourhoods and high streets, social media and educational institutions.

Practical examples of activities include:

  • Creation of compassionate policies; for example, a workplace can officially give help and support to those people with terminal illnesses, carers or people who have experienced grief and bereavement
  • Asking for volunteers within an organisation to act as emotional support and to be a listening ear. This may be people with a natural affinity for such work, or people who have experienced loss, which may be of help to others.
  • Having a volunteer ‘bank’ of people who are prepared to do tasks, such as giving lifts, covering colleagues at work, collecting children from school.

A growing number of communities across the UK have taken the initiative to become “compassionate”, with a range of local focal points. Engagement of professional healthcare providers to help establish local initiatives is welcomed and often time-sensitive.

Community pharmacies are ideally placed to contribute to these initiatives as part of their role in promoting health and wellbeing. They can play a key role in raising awareness, providing information and signposting of individual carers to a local network or similar resources. A pharmacy can be seen as a “compassion hub”, encouraging conversations about palliative care, death and bereavement, normalising taboo subjects and building community resilience.

Community pharmacies can also link in with existing supportive networks, e.g. bereavement services.

The ‘Daffodil Standards’ for Palliative and End of Life Care have been developed by RPS and Marie Curie UK Community Pharmacy Quality Improvement to assist and encourage local pharmacy teams to improve the quality and consistency of support.

We look forward to supporting the implementation of these Standards later this year.


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