Pharmacists should be ‘fully integrated’ into palliative and end of life care so that patients can access the medicines, support and joined up care they need, a new policy report from the Royal Pharmaceutical Society (RPS) has said.
Originally published by RPS Wales in 2018, this updated policy report now reflects guidance from across Great Britain and calls for several reforms, underpinned by a need for improved information sharing and access to patient records across the multidisciplinary team to ensure a seamless transition of care in which quality is maintained.
‘If a patient is to truly have the power to choose their care setting for end of life, there should be no compromise in terms of the care and support they should expect to receive whether it’s at home, in a hospice or hospital setting,’ the report said.
The proposed reforms included embedding pharmacists in all multidisciplinary palliative care teams to provide expertise on medicines, including prescribing and deprescribing. And Integrated Care Boards (ICBs) or Health Boards ‘must commission’ a lead paediatric palliative care pharmacy role in each country or region, it added.
Having specialist pharmacists actively participating in the multidisciplinary palliative care team means that they can ‘provide direct clinical expertise and be accessible for patients within every hospital as well as in community and primary care settings to ensure consistency in patient support and care’, the report said.
It also highlighted the need for a single patient record – as promised in the Government’s 10 Year Health Plan – which is particularly important in the final stages of life when changes can be rapid.
Other recommendations included faster access to urgent and controlled drugs, especially out-of-hours, to avoid hospital admission, and support for families with medicine disposal and signposting to services post-bereavement.
Professional progression and education
While the majority of the reforms and benefits raised by the RPS focused on patients and their families, the report also highlighted that ‘a structured approach to specialist pharmacists in palliative care will support a sustainable consultant pharmacist workforce, providing a career pathway, succession planning and workforce continuity’.
The importance of a supportive development pathway and pharmacists’ evolving role in patient care was a key part of the RPS response to the Government’s call for evidence for the forthcoming NHS workforce plan.
The need for education and training was also outlined in this latest policy report. It referred to an inquiry report from the Cross Party Group on Hospices and Palliative Care in Wales, which encouraged the Welsh Government to ‘work with Health Education and Improvement Wales and external partners, such as the Royal Colleges, to incorporate annual mandatory training in palliative care for all hospital-based clinical staff as part of their Continuous Professional Development’.
While the RPS voiced its support for this statement, it added that this annual mandatory training in palliative care should be extended to ‘incorporate all frontline health and social care workers if we are to help shift more care into community settings’.
Indeed, the NHS 10-year plan confirmed Government plans to launch neighbourhood health centres to move ‘the majority of outpatient care’ outside of hospitals and into the community by 2035.
Shifting palliative care to community
The RPS policy report comes as a separate independent expert panel report from the Health and Social Care Committee (HSCC), also recognised pharmacy’s role in palliative care.
This report on England’s palliative and end of life care services highlighted the ‘vital element of care’ pharmacists provide but also said that shifting palliative care into the community would be challenging, due to current funding approaches and the fact that there are ‘no 24/7 pharmacies’ in some regions.
‘The Government’s overarching strategy for the NHS, for more services to be delivered in neighbourhood or community settings rather than in hospitals, applies strongly to palliative and end of life care.
‘However, spending on primary and community health care accounts for 11% of health expenditure for people in their last year of life, while hospitals receive 81% of the spending,’ it said.
The report concluded that the NHS workforce is ill-equipped to meet the needs of people at the end of life due to insufficient education and training, staff shortages, and the lack of a nationwide framework for how ICBs should commission palliative care services.
The Government has recently announced that a Palliative Care and End of Life Care Modern Service Framework for England is in development, with a planned publication date of Spring 2026.
Navigating fragmented palliative care
RPS president Professor Claire Anderson said: ’Patients and their families should not have to spend their final months navigating fragmented care.
‘Pharmacists are central to helping people stay comfortable and supported at the end of life, but too often they are working without access to vital information or key systems.’
She urged the wider NHS, and those involved in end-of-life care, to follow the recommendations set out in the RPS policy report and ensure people receive safe, timely and compassionate care during the last phase of life.
Dr Sarah Holmes, chief medical officer at Marie Curie, added: ‘Pharmacists have the skills and accessibility to make care faster and easier to access for patients and their families; they’re an essential part of end of life and palliative care.
‘As a leading palliative and end of life charity, we have long called for better integration between services, so we welcome this call for urgent reform. Dying people need access to care that is within reach for them – right on their doorsteps – and pharmacists along with the wider NHS play a vital role in providing this.’
The assisted dying bill
It also comes as the Terminally Ill Adults (End of Life) Bill, known as the assisted dying bill, is making its way through Parliament. This bill would allow terminally ill adults in England and Wales with fewer than six months to live to apply for an assisted death, with the approval of two doctors and a panel that includes a social worker, legal figure and psychiatrist.
The bill was supported by MPs on its final reading in the House of Commons in June and it is now in its final stages in the House of Lords.
However, peers have proposed more than 900 changes and, last week, the Government’s chief whip in the Lords has announced an additional 10 days to scrutinise the bill, between 9 January and 24 April 2026.
Health secretary Wes Streeting voted against the bill, with the quality of end-of-life care being one of the reasons he cited for this decision.
Some 568,613 people died in England and Wales in 2024, with an estimated 90% requiring some level of palliative care.
