Clinical guidelines and resources for healthcare professionals

These pages contain a selection of locally developed guidelines, links to national guidelines and other resources relating to palliative care.

Please note this is not an exhaustive list of guidance for the area which the hospice covers. Many acute trusts and Clinical Commissioning Groups (CCGs) have additional local policy/guidelines, so ensure you also refer to those for the area where you work.

Remember 24-hour specialist palliative care advice is available by calling our advice line on 0117 915 9430.

Do come back to this page. We review the contents every six months and there may be updates or additions in the interim.

  1. Local clinical guidelines
  2. Local services for end of life care
  3. DNACPR (do not attempt cardiopulmonary resuscitation) form
  4. Advance Care Planning (ACP)
  5. Other links

1. Local clinical guidelines

All these local guidelines have had input from a number of specialists in Palliative Medicine eg Bristol Palliative Care Collaboration (BPCC) which includes all the palliative medicine consultants (hospital and hospice) in Bristol. Some have had wider consultation and approval for use in a specific geographical area eg Bristol, North Somerset and South Gloucestershire (BNSSG) or Wessex. The source and (where applicable) geographical area is identified for each one.

  • Guidelines on the management of pain due to cancer in adults (BPCC). Includes advice on starting and changing opioids plus easy opioid conversion tables. (Updated 2017)
  • The palliative care handbook, eighth edition (Wessex Specialist Palliative Care). Detailed advice on clinical management.
  • Anticipatory prescribing for end of life symptoms in the community. (Regional Anticipatory Prescribing Project and BPCC). A new community drug chart for the authorisation of injectable palliative care medication (PRN and syringe pump) and new patient information leaflets have been introduced in Bristol, North Somerset and South Gloucestershire. The drug chart is available in booklet format from the District Nurse or End of life co-ordination teams and a printable version is being developed for use in EMIS.
  1. Community palliative care prescribing table: injectable and syringe pump medication for symptom control. (BPCC)
  2. Pharmacies in BNSSG: stocking specialist palliative medicines (updated July 2017)
  3. List of drugs stocked in specified pharmacies
  4. Guidance notes and resources for BNSSG
  5. Anticipatory Prescribing: full standard operating procedure and guideline (BNSSG)

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2. Local services for end of life care

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3. DNACPR (do not attempt cardiopulmonary resuscitation) form

The form, for recording DNACPR decisions, has been agreed across BNSSG and by South Western Ambulance Service. It is valid across all care settings in the area and for all journeys in between. The decision must be communicated to SWAS and relevant others. The original form should stay with the patient and the patient/carer must know about the form if it is to be in their home.

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4. Advance care planning (ACP)

General ACP information

Preferred priorities of care (PPC)

An individual can use a PPC to record their preferences and wishes regarding end of life care. It can not be used to make legally binding refusals of treatment.

Advance decision to refuse treatment (ADRT)

ADRT forms provided with permission from 'Deciding Right and The Northern England Clinical Networks'

  1. Fillable form (to download and complete)
  2. Print form (for handwritten completion)

Lasting power of attorney (LPA)

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5. Other links

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