Covid-19 & End of Life Management
COVID-19 & End of Life Management
The following documents have been regionally endorsed by the PCiP programme and can be used when caring for a person in the last days of life in all care settings (at home, in a care home, a hospice or in hospital).
| This guidance has been prepared by the Regional Palliative Medicine Group (RPMG) in Northern Ireland with input from the NI Specialist Palliative Care Pharmacy Group and supported by the Palliative Care in Partnership Programme. It is relevant for use in both secondary and primary care settings and specific for managing patients with Covid-19 in the last days of life.
When caring for patients without Covid-19 in the last days of life, the original Guidance for Symptom Management in Adults in the Last Days of Life (RPMG 2023) should be used. The link below provides some teaching from Dr Caroline McLoughlin, Palliative Medicine Consultant, Southern Health and Social Care Trust. It covers the RPMG Covid 19 Symptom Management in the Last Days of Life Guidelines and tips for communication in these exceptional circumstances. The video is 40 mins long but if you would like to go a specific topic there is time stamp information available in the Youtube description. For the most up to date symptom management guidance please refer to the Covid-19: Symptom Management in the Last Days of Life Guidance which can be downloaded above. |
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| Northern Ireland guidelines on converting doses of opioid analgesics for adult use (HSC 2023) | |
| Regional arrangements for palliative care medicines during Covid-19 pandemic
In response to the COVID-19 pandemic, the Health and Social Care Board (HSCB) has been working with relevant stakeholders, to support the availability of essential medicines for palliative/end of life patients. HSCB has agreed a list of medicines and quantities to be added to the routine stock holding in all Community Pharmacy Network and Supply pharmacies with immediate effect. Community Pharmacy Palliative Care Network pharmacies are spread throughout Northern Ireland and aim to increase access to community pharmacy palliative care services. They can supply medicines from the palliative stock list or be contacted for advice. Download Community Pharmacy Palliative Care Network information here. More information about Palliative Care Pharmacy services can be accessed here: http://www.hscbusiness.hscni.net/services/2481.htm There has been an unprecedented demand for many medicines and HSCB have made requests not to stockpile. The medicines stock situation is being monitored closely on a daily basis with wholesalers and community pharmacies. The aim is that medicines stock is accessible for patient care at the right time and in the right place and therefore it is imperative that stock piling of these drugs does not occur at this critical time. Urgent Pandemic Packs for Nursing Homes Health and Social Care Board (HSCB) have also arranged the distribution of Urgent Pandemic Packs to Nursing Homes with 59 beds or more. The medication in these packs should be used to provide timely access to patients requiring clinically urgent medication and guidance to support the use of these packs will be issued to eligible nursing homes prior to delivery w/c 13th April 2020. For more information on the Urgent Pandemic Packs for Nursing Homes please visit the link below: http://www.hscbusiness.hscni.net/services/3137.htm Policy for assessment of un-used prescribed medicines for the potential to re-use in care homes (nursing and residential care homes) and hospices In response to the COVID-19 pandemic, RQIA, PHA, Trust and HSCB Pharmacy Colleagues have been working together to develop policies and guidance across a range of medicines management areas to support services across care settings. As part of this, a Policy for Assessment of Un-used prescribed Medicines for the potential to Re-use in Care Homes (Nursing and Residential Care Homes) AND Hospices has been developed and can be accessed at the following link: http://www.hscbusiness.hscni.net/services/3141.htm This policy will take immediate effect during the Covid-19 pandemic and will remain in place until 30th June 2020 or earlier if stood down following further correspondence. Visitor Guidance for In-Patient Settings during Covid -19 On 11 May 2020, the Chief Nursing Officer released updated visitor guidance for in-patient health settings. This guidance includes Principles for End of Life Care: Facilitating Patient Visiting at end of Life during COVID 19 Pandemic and can be downloaded here. Verification of Life Extinct Training It is recognised that during the Covid-19 pandemic there is a need to increase the number of people appropriately trained to verify life extinct. Verification of life extinct is a key part of the death process and a task which nurses and paramedics across the HSC system can do, if appropriately trained. Increased capacity in appropriately trained staff who can verify life extinct will relieve pressures on medical practitioners particularly in community settings. To help increase capacity of healthcare staff who can verify life extinct the HSC Clinical Education Centre is offering free online training. For more information please visit https://cec.hscni.net/ and search for ‘Verification of Death’ under ‘Programmes’. Covid-19 Guidance Surrounding Death A range of guidance surrounding deaths in Northern Ireland during Covid-19 has been developed and is available on the Department of Health website at the link below: https://www.health-ni.gov.uk/publications/covid-19-guidance-surrounding-death This guidance includes new arrangements for completing and issuing Medical Certificates of Cause of Death and guidance for verification of life extinct during Covid-19. |