Pathfinder enables Foyle Hospice Community Team to prescribe for patients in their own homes

Date published: 17 June 2025

A pathfinder, which was established recently to test new models of prescribing and supply, has enabled Foyle Hospice staff to prescribe medicine to palliative patients living in their own homes.

The pathfinder enables specialist palliative care doctors and nurses to directly prescribe, which is then supplied via local community pharmacies. This has shown benefits in reducing patient waiting times to access medicines, freeing up GP capacity, and helping patients approaching the end of life to receive care in their own homes.

Professor Cathy Harrison, Chief Pharmaceutical Officer, Department of Health, said: 

“Gaps in the care provided to palliative care patients in the community have been highlighted over the past number of years. A significant challenge has been access to timely prescribing and supply of vital medication needed for symptom relief at the end of life.

“This pathfinder is a prime example of developing novel prescribing and supply models to ensure we meet the needs of this population more effectively, deliver care in the community and maximise capacity within existing resource.”

Prior to the pathfinder project, specialist palliative care doctors and nurses operating within Foyle Hospice needed to contact the patient’s GP to ask them to prescribe medicines on their behalf. The pathfinder ran from September 2024 to March 2025 and enabled more timely access to supply of palliative medication.

Hospice prescribers participating in the pathfinder can directly write prescriptions, where appropriate, for medicines required urgently or where increased doses of existing medication are needed that can be supplied from a local community pharmacy.

The Foyle Hospice Community Specialist Palliative Care Team provide professional palliative care expertise and support to patients and their families in the comfort of their own home. The management of symptoms and psychological support are key elements in enabling many patients to remain at home.

Donall Henderson, Chief Executive, Foyle Hospice said, 

“Many people with life limiting conditions wish to have their palliative care needs met in the community. This pathfinder has improved access to medicines, reduced duplication of effort and utilised the skills and experience of specialist palliative care professionals.”

A local GP and member of the Task and Finish Group responsible for establishing the pathfinder, Dr Donna Mace, welcomed this new arrangement, 

“Patients have timely access to medication and are receiving the right medicine at the right time from the right healthcare professional.”

To assist with wider implementation of the model, the Medicines Optimisation Innovation Centre have independently evaluated the pathfinder. This new approach to prescribing has influenced positive partnership working. As a result of the pathfinder’s success, a recommendation will be made to incrementally adopt HS21 prescribing into standard practice by all Hospice settings throughout Northern Ireland.