Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps he is taking to improve out-of-hours access to medicines for people at the end of life.

The Government is committed to ensuring that people at the end of life can access the medicines they need, including outside of normal pharmacy opening hours.

Palliative care services are included in the list of services an integrated care board (ICB) must commission. This promotes a more consistent national approach and supports commissioners in prioritising palliative care and end-of-life care. To support ICBs in this duty, NHS England has published statutory guidance and service specifications.

NHS England’s statutory guidance states that ICBs work with community pharmacies, out-of-hours providers and palliative care teams to ensure timely access to medicines, including through locally commissioned services that make end of life medicines available on a 24/7 basis.

Additionally, those nearing the end of life who are likely to need symptom control can be prescribed anticipatory medicines with written instructions for how to use or administer treatment. These medicines are often called 'just in case' medicines and may be provided in a specially marked container called a 'just in case' box. The medicines are prescribed in advance so that they can be obtained during local pharmacy opening hours and kept safely at home, or at a care home, so that the person or their carer has access to them if they develop symptoms. Providing medicines in advance means that there is no delay in getting medicines that might be needed quickly to help with symptoms. The use of anticipatory prescribing is recommended in the National Institute for Health and Care Excellence guideline, Care of dying adults in the last days of life.

Furthermore, the Government will publish a Palliative Care and End-of-Life Care Modern Service Framework (MSF) for England later this year. The MSF will drive improvements in the services that patients and their families receive at the end of life and enable ICBs to address challenges in access, quality and sustainability through the delivery of high-quality, personalised care.