Foyle Hospice Pilot Lets Clinicians Prescribe Directly to Patients at Home
A six-month pilot at Foyle Hospice has shown that giving specialist palliative-care doctors and nurses the authority to prescribe medicines directly can speed up access to symptom-relief and ease pressure on GPs.
The “pathfinder” programme, which ran from September 2024 to March 2025, allowed hospice prescribers to issue HS21 prescriptions that were then dispensed by local community pharmacies. Early results indicate:
- Faster access to medicines for patients approaching the end of life
- Reduced calls to GP surgeries, freeing up capacity during winter pressures
- Greater ability for patients – and their families – to receive care in the comfort of their own homes
“Timely prescribing has long been a pinch-point in community palliative care,” said Professor Cathy Harrison, Chief Pharmaceutical Officer at the Department of Health. “This pilot demonstrates how novel supply models can close that gap while working within existing resources.”
Before the trial, hospice clinicians had to phone or email a patient’s GP to request prescriptions, causing delays in urgent dose changes. Under the new arrangement, prescriptions are written and sent to a pharmacy immediately after a home visit.
Donall Henderson, Chief Executive of Foyle Hospice, said the approach “reduces duplication of effort and uses the full skill-set of specialist palliative-care professionals,” adding that most patients would prefer their care to remain in the community whenever possible.
GP representative Dr Donna Mace described the model as “right medicine, right time, right professional,” and praised the reduction in paperwork and callbacks.
The pilot has now been independently evaluated by the Medicines Optimisation Innovation Centre (MOIC). On the back of its positive findings, a task-and-finish group will recommend a phased roll-out of HS21 prescribing across all hospice settings in Northern Ireland.
Next steps
- Final evaluation report due later this summer
- Department of Health to consider region-wide adoption ahead of winter 2025–26
- Ongoing monitoring of patient outcomes, GP workload, and pharmacy supply chains
If adopted, the scheme could become a template for other community-based prescribing initiatives aimed at keeping patients out of hospital and in familiar surroundings at the end of life.