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Clinical Guidelines
The clinical guidance section of this website provides links to local guidelines and protocols where available.
For situations where local guidance is not currently available links have been provided to national guidance (including devolved nations) and key reference texts.
For specialist palliative care clinical advice and support after 5pm or at weekends please ring the palliative advice line on 01736 757707. Please note this is not an emergency service.
Anticipatory prescribing guidance (APG)
For symptom dosing advice it is recommended that prescribing decisions are informed by the Cornwall and Isles of Scilly anticipatory prescribing guidance in addition to the patients established drug regimen:
Guidance for anticipatory prescribing and symptom control at the end-of-life (cornwall.nhs.uk)
Renal anticipatory prescribing guidance
Syringe driver prescribing guidance
- For advice on subcutaneous prescribing and administration including syringe driver management:
Rapid reference guide to subcutaneous prescribing in the last days of life (cornwallft.nhs.uk) - For syringe driver drug compatibility calculator:
Palliative Care Guidelines Plus (pallcare.info) - The Cornwall Joint Formulary
Diabetes
For advice on managing diabetes at end-of-life please see the Management of Diabetes Mellitus for Adults Requiring End of Life Care Joint Clinical Guideline.
Bowel Obstruction
For advice on identifying and managing intestinal obstruction: Bowel obstruction | Right Decisions.
Palliative care emergencies
For advice on recognising and managing palliative care emergencies including malignant cord compression, hypercalcaemia and raised intercranial pressure etc: Emergencies overview | Right Decisions.
Spiritual care
Providing spiritual care is an important part of palliative care. All health and care professionals and help support and explore a person’s spiritual needs. The Marie Curie webpage has lots of useful information for professionals including assessing someone’s spiritual needs, providing spiritual care, and taking care of yourself.
Best practice in palliative and end-of-life-care
Education Opportunities
Cornwall End of Life Education Strategy
The End of Life Education Strategy demonstrates a framework of the recommended End of Life Care (EoLC) Learning Outcomes (LOs) and goals for all health and social care professionals involved in the delivery of care to individuals at the end of their lives, with the overall aim to improve the standards of EOLC delivered through identifying the minimum recommendation of educational needs dependent on role and setting. The strategy has by been developed by Cornwall and Isles of Scilly End of Life Education Group, represented by disciplines in conjunction with partner organisations.
Cornwall & Isles of Scilly End of Life Learning Path
The Cornwall End of Life Learning Path was launched in November 2019, it was developed by members of the Cornwall End of Life Education Group with the support of the e-LfH (e-learning for health care) programme team.
The learning path has been developed to guide and support primary, secondary and social care staff. It is supported by a handheld passport, which provides a platform for discussion and evidence of learning. To find out more information or to register for the learning path please follow the link below:
Cornwall & IOS End of Life Learning Path (cornwallhospicecare.co.uk)
Programme of Education
We are committed to supporting people involved in all areas of end of life care. The Palliative and End of Life Care Education Calendar of Events can be accessed via the Cornwall Hospice Care website.
As well as your established organisational education programmes Cornwall Hospice Care offer high-quality education and training to all staff across a wide range of settings, including hospitals, residential/nursing homes, care agencies and individual carers. You can find out more about the courses and formats they offer on the Training Courses page.
The Palliative and End of Life Care Education Calendar of Events can be accessed here.
Communication Skills Faculty
The importance of effective communication is generally recognised in all health and social care settings and relationships – it is part of everyday practice. It has special significance when caring for people at the end of their lives as conversations about death and dying can be the most challenging of all communication scenarios. Cornwall & Isles of Scilly End of Life Education Group aspires to establish a robust long-lasting Communications Skills Faculty to ensure all health and social care staff working with patients and their families feel supported and confident and have access to the right level of training and education for their individual needs. Find out more information regarding the training available for you.
Self-Care and Wellbeing
The Hospice UK website has lots of useful information and advice for how to look after yourself whilst caring for someone at the end of their lives.
Key contact numbers
For advice and symptom control
Cornwall out of hours treatment for patients with palliative care needs
For patients with palliative care needs. Clinician phone back aimed within 20 minutes. Support includes advice, home visit within two hours and prescriptions. 6.30pm to 8am on weekdays and all day at weekends. Find out more: call 01872 224050 or email: enquiries.kernowcic@nhs.net.
Professionals Palliative and End of Life Care Advice Line
Specialist telephone advice with access to consultants. Open 24/7 – call 01736 757707.
Community specialist palliative care nurses
Face to face and phone contact 7 days a week, 9am to 5pm. Call 01208 251300.
Cornwall professional’s line
Call on 01872 303770. This single line includes Cornwall Care Coordination Hub, Care Home Support Team, Integrated Transfer of Care Hub, Falls Response Service, Acute GP service, Community Assessment Treatment Unit (CATU) and Virtual Wards.
For admissions
Cornwall Hospice Care
Inpatient admissions to hospices 24/7. For hospice admissions please call 01736 757707.
Enquire about a hospice admission.
St Luke’s Hospice
Plymouth. Open 24/7, call 01752 401172.
Visit the St Luke’s Hospice website.
Children’s Hospice South West
Short breaks, respite, counselling, sibling support, EOL care, bereavement support. Open 24/7, call 01726 871 800.
Visit the Children’s Hospice South West website.
For nursing or care home admissions, see below Marie Curie Coordination Centre
For general care and support
Marie Curie Coordination Centre
For all requests for continuing health care funded end of life care at home and in bedded placements, and night service countywide. Call the co-ordination team on 0845 073 8696 or submit referrals on the ‘EOL application form’ via email to lat.mcsw.cornwall@nhs.net Open Monday to Friday 8am to 6pm and 8am to 4pm at weekends.
Community Gateway
The Community Gateway is a dedicated telephone line available for everyone and provides access to a wide range of professional voluntary sector support. Open 8am – 8pm, seven days a week, 365 days a year.
- Telephone: 01872 266383
- Email: gateway@ageukconrwall.org.uk
Lymphoedema clinics
Cornwall Hospice Care Specialist Lymphoedema practitioners offer clinics at both Mount Edgcumbe Hospice, St Austell and St Julia’s Hospice, Hayle offering a range of treatments to help patients manage their symptoms and live life as well as possible. Find the referral form and details here.
Neighbourhood Hubs
Cornwall Hospice Care offer support, practical advice, information and treatment for people living with a palliative/terminal illness or deteriorating progressive disease and their carer. Find further details and how to refer here.
Advance Care Planning and Treatment Escalation Plans
Advance Care Planning
Advance care planning provides people with the opportunity to record their wishes and preferences for end-of-life care ahead of time. This is particularly relevant to those people with advanced incurable illness, frail and elderly people, or those groups for where a deterioration in cognition is likely, such as those affected by dementia.
As health and social care professionals many of us are in an opportunity to support people in completing their advance care plan, either by opening the conversation, giving information, or helping people to complete all, or part of their plan.
At times it can feel difficult to incorporate activities like advance care planning into our busy working days, even when we recognise their benefit. We have a growing number of local resources to support our health and social care colleagues.
Across our health system in Cornwall, we are committed to supporting our patients achieve what matters to them at the end of their lives. Understanding what those priorities are is the first step in achieving that.
Royal Cornwall Hospitals hosts our local advance care planning webpage. This provides links to National and disease-specific websites. On this page, you can find a patient information leaflet, and an advance care plan template.
In 2022 NHSE launched the Universal Principles for Advance Care Planning to support the completion and utilisation of an Advance Care Plan.
Access local training on the principles and processes of Advance Care Planning.
Treatment escalation planning (TEP) and resuscitation decisions
Please use the links below for information about treatment escalation planning and resuscitation decisions:
Page last reviewed: 11 January 2024