The LMC has worked with the relevant personnel regarding palliative care medication authorisitions in LLR, and we can confirm the LLR position regarding palliative care medication authorisations, following recent alignment work across hospital and community processes.
Hospital-initiated authorisation forms
- Hospital authorisation forms remain valid for 14 days.
- The wording has now been updated to mirror the community authorisation form, although we acknowledge that the Nervecentre version is still unable to fully replicate the community layout.
Community-initiated authorisation forms
- There is now no expiry date on community-initiated authorisation forms.
- This change supports continuity of care and reduces the need for repeated re-authorisation.
Risk mitigation – new ‘Clinical Discussion’ process
To mitigate risk where there is no expiry on community authorisations, a new process has been introduced:
- A ‘Clinical Discussion’ must take place prior to administration.
- This ensures the medication remains clinically appropriate at the time of use.
Full details of the Clinical Discussion process, including documentation requirements, can be found here:
https://www.areaprescribingcommitteeleicesterleicestershirerutland.nhs.uk/wp-content/uploads/2024/09/Guidance-doc-authorisations-FINAL-7.pdf
Ongoing challenges
We are aware of some ongoing challenges, particularly within district nursing teams, around consistent documentation of Clinical Discussions. Work is currently underway with LHIS to improve compliance and support teams with this process.
Any questions regarding the above, please contact the LMC office.