How the RPS Daffodil Standards helped us improve end of life care

By Patricia Ojo, RPS CPEAG member and Independent Prescriber at Stevens Pharmacy

Community pharmacies are the cornerstone of patient care, offering essential services that extend far beyond dispensing medications. Our pharmacy recognised the need to elevate our commitment to palliative and end-of-life (EoL) care and decided to adopt the RPS Daffodil Standards. I’m so glad we did.

I previously blogged about the start of our journey a year ago. This decision not only built on our existing work but also reinforced our role in supporting patients and carers at the most critical times of their lives. The Standards are part of a partnership with end of life charity Marie Curie who gave us a fantastic pack to start us off on our journey.

Why we embraced the Daffodil Standards

The Standards provided a way to formalise and enhance the quality of care we provide. I wanted to signal that our pharmacy team is capable and committed to delivering the highest standards of care. The Daffodil Standards indicate that we have stepped up to another level of service excellence, which also built the confidence of the team. By focusing our efforts and having structured conversations, we ensured that we were doing what was right, not just what we thought was right.

Team benefits from the standards

Implementing the Daffodil Standards was embraced enthusiastically by our team, providing valuable professional development for us all.

As part of this journey, I undertook the CPPE palliative care course, which deepened my understanding and commitment to EoL care. We also participated in NHS England’s Pharmacy Quality Scheme and became one of the pharmacies providing all 16 critical medicines for palliative and end of life care in our area. Through all this, we worked with the provider arm of South East London Pharmacy Alliance to support our local Integrated Care Board extend the provision of further medicines as an Enhanced Service. Providing this ES encouraged me to try and build closer links with the multidisciplinary team.

Enhancing care through the Daffodil Standards

Implementing the Daffodil Standards has been transformative for us. Initially, we audited our current practices and identified areas for improvement. This process fostered more meaningful conversations with patients and healthcare professionals. For example, by proactively contacting the local NHS palliative team, we helped them understand we could facilitate access to the range of critical medicines patients need.

Although integrating these practices required time and effort, it was a natural extension of our day-to-day responsibilities. Asking additional questions and having more in-depth conversations with patients and/or carers has not been a burden or time-consuming but incredibly rewarding. Seeing the relief and appreciation on patients' faces has reinforced the importance of our work.

Impact on patients and carers

The feedback from patients and their families has been overwhelmingly positive. We have established special connections with those we serve. One case that stands out involved a family who were so grateful for our support that they brought us fresh vegetables from their garden. This kind of personal connection demonstrates that our role extends beyond dispensing medications—we are integral to their care and support network.

Additionally, patients have shared more about their health needs, enabling us to provide even better care. Families even sometimes share the booklets from their loved one’s funeral service with us, highlighting the trust and connection we have built.

Challenges and future support

While the journey has been rewarding, we have faced challenges, particularly in accessing local palliative care specialists. Improved communication and collaboration with these specialists are crucial to integrate community pharmacy services effectively into the palliative care pathway. More resources, such as additional leaflets and display materials, would help raise awareness and inform patients about the support available in the pharmacy too.

Reflecting on our journey

Adopting the Daffodil Standards has been an eye-opening and enriching experience. It has made us more curious and determined to address gaps in care. When your time on earth is limited, every moment of quality care matters, and it’s so rewarding to help provide that.

We believe our pharmacy’s role in palliative and EoL care is vital, and with better integration into multidisciplinary teams, we can enhance the support we provide. A simple step to integration of community pharmacy teams is to identify from the patient/carer their existing community pharmacy and gain consent to inform the pharmacy when they are palliative. This will bridge a gap which often occurs when pharmacies are only aware of patients’ needs later in a process which can tend to feel rushed/time pressured.

As we continue this journey, we are committed to upholding the standards and ensuring that every patient receives compassionate, informed, and high-quality care at the end of life.