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REMEDY : BNSSG referral pathways & Joint Formulary

BNSSG Adult Joint Formulary
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16. Palliative Care

First line drugs Second line drugs Specialist drugs Secondary care drugs
Recommended in both primary and secondary care Alternatives (often in specific conditions) in both primary and secondary care Where a specialist input is needed (see introduction for definition) Prescribing principally within secondary care only


  • There is information at the beginning of the BNF on prescribing in palliative care and  St Peter's Hospice Guidelines for the management of pain due to cancer in adults for advice on clinical management.
  • Several recommendations in this chapter involve the use of medications outside of their product license i.e. ‘off-label'. This increases the prescriber's responsibility. Please contact Pharmacy for further information.
  • Please see St Peter's Hospice website for more local information here


NHS England Community Pharmacy Specialist Medicines LES

A number of pharmacies across the South West are providing the NHS England Enhanced Service for the Availability of Specialist Medicines. By providing the Specialist Medicines Enhanced Service, pharmacies are required to ensure that the specialist medicines are available at all times during their opening hours and on any bank or public holidays on which they open.
Pharmacies currently providing the service can be found here and the medication they hold can be found here. For more information on the NHS England LES please click here. Please note the medication list is subject to change during the pandemic and may need to be revised as guidance and/or availability of medicines changes.
It is advised to always ring the pharmacy to check current stock and opening times.