Palliative Care Guidelines

Prescribing Advice relating to Care in the Last Days of Life

End of Life Discharge Planning

Prescribing for End of Life Care

Excellence in end of life care including brief prescribing guidance

 How to Prescribe Controlled Drugs

 Opioid Conversion Calculator




Flow chart for what to do with transdermal analgesia when patients are entering the terminal phase

Transdermal Patch where eGFR greater than 30 mmols/l 

Transdermal Patch where eGFR less than 30 mmols/l 



Management of Diabetes in the Last Days of Life   

Management of Blood Sugars when on Steroids


Gloucestershire’s Shared Care Record for the Expected Last Days of Life 

This resource was developed through a countywide working party representing all key care agencies.  The care record provides a structured document for recording care with prompts over the areas that should be addressed.  It is transferable between care settings within Gloucestershire.  Shared Care Records should be available within your clinical area but can be viewed through the links below.  

Intranet Link

Internet Link

Ordering the Shared Care Records


What to do for advanced renal disease

Supportive Care for Advanced Renal Disease

Guidance on identifying and supporting patients with advanced kidney disease - prescribing for common symptoms when to refer to palliative care/dieticians and care at the end of life.

See pages 11 and 12 which guide adjustments in end of life prescribing for patients with advanced renal disease.


Additional Documents

Guidelines for the Use of Symptom Control - West Midlands

Pocket guide giving general advice on management of symptoms in palliative patients.


Management of Bleeding in Head and  Neck Cancers

Approach to management of patients at risk of bleeding including catastrophic terminal haemorrhage/actute shortness of breath


Management of Intractable Breathlessness

Multiprofessional document with approach to managing breathlessness in advanced disease


Mouthcare Guidelines

A set of countywide resources.  


Acute Oncology Guidelines


Archived Additional Guidance for Palliative Patients - useful further reading

Use of Corticosteroids in Palliative Care

Use of and monitoring of corticosteroids for palliative conditions


Breaking Bad News