Daffodil standards
The Royal Pharmaceutical Society (RPS) has partnered with Marie Curie to develop the Daffodil Standards, which align with the eight standards that are used in general practice and have been adapted to reflect the way community pharmacies work.
The Daffodil Standards are quality improvement standards that provide an evidence-based framework for community pharmacy teams to self-assess and identify areas to improve their existing palliative care provision and provide better quality care for patients and carers.
There are eight Daffodil Standards:
- Professional and competent staff
- Early identification
- Carer Support before and after death
- Seamless, well-planned, coordinated care
- Care is based on the assessed unique needs
- Quality care during the last days of life
- Care after death
- Community Pharmacy linking with Compassionate Communities hub
The following resources can be used to support implementation of the Daffodil Standards and to provide advice and support patients with palliative care needs and carers of individuals with palliative care needs.
Further information on the Daffodil Standards can be accessed via the RPS website.
The Quality Improvement Skills Training (QIST) programme provides the opportunity for members of the pharmacy team to develop quality improvement skills to support implementing the Daffodil Standards.
For any queries relating to the implementation of The Daffodil Standards in community pharmacy, please email the RPS directly.
For non-urgent queries relating to the provision of palliative care from community pharmacy, the following Health Board Key Contacts can be contacted.
Aneurin Bevan University Health Board
Hywel Dda University Health Board
Swansea Bay University Health Board
Cwm Taf Morgannwg Health Board
Cardiff and Vale University Health Board
Powys Teaching Health Board
Betsi Cadwaladr University Health Board
Central: bcu.spctcentral@wales.nhs.uk
The following can be utilised as a point of reference to refresh knowledge and support providing pharmaceutical care to patients with palliative care needs.
NICE Guidance 31 provides guidance on managing the clinical care of adults in the last few days of life, including the management of common symptoms experienced by patients at the end of their life.
Clinical Knowledge Summaries (CKS) have been developed on behalf of NICE and provide user friendly evidence-based summaries for a variety of palliative care topics.
The Scottish Palliative Care Guidelines cover various palliative care topics.
The Palliative Care Adult Network Guidelines provide palliative care resources including the Palliative Care Adult Network Guidelines (PANG), syringe driver drug compatibility tool and opioid dose convertor. Resources can be accessed for free via the mobile-friendly website, registration is required.
GatewayC provides accessible, free evidence-based information to support the early detection of cancer, registration is required to access.
The National Palliative and End of Life Care Programme (PEoLC) works with healthcare professionals and community organisations to help improve palliative and end of life care services in Wales. Resources for both patients, carers and healthcare professionals are available on the National PEoLC Programme website including the All-Wales Care Decisions for the Last Days of Life Guidance.
A National PEoLC Programme bulletin is available, providing a quarterly update on the PEoLC programme.
The following resources can be used to support with medication related queries.
The British National Formulary (BNF) and the British National Formulary for Children (BNFc) include key information on the prescribing, dispensing and administration of medications. The BNF and BNFC can be accessed online or via the BNF and BNFC apps for smartphones and tablets.
Palliative care prescribing advice can be accessed online via the BNF and BNFC or the BNF apps for smartphones and tablets.
The Electronic Medicines Compendium (emc) provides Summary of Product Characteristics (SPC) including key prescribing information and Patient Information Leaflets (PIL) for licensed medications.
The Specialist Pharmacy Service provides information on the safe and effective use of medicines in patients with swallowing difficulties. It should be noted that the information provided may be outside of product licensing.
The NEWT Guidelines provide information on the administration of medications to patients with swallowing difficulties. However, it should be noted this information may be outside of product licensing.
The Palliative Care Adult Network Guidelines include a syringe driver drug compatibility tool and opioid dose convertor. Resources can be accessed for free via the mobile-friendly website, registration is required.
The Medicines Advice Service provide an enquiry answering service to healthcare professionals and can support with a variety of different enquiries including medication administration enquiries. Information for your local Medicines Advice Service can be found on the following website.
The Palliative Care Formulary provides information on a variety of topics relating to the care of adult patients with palliative care needs including information on routes of medication administration and drug monographs. The Palliative Care Formulary is available via Medicines Complete and can accessed using an NHS Wales email account and password or for those without an NHS Wales account, via an NHS Wales OpenAthens account.
Details on how to register for an NHS Wales OpenAthens account can be found here.
Each Health Board in Wales has a formulary listing the medications approved for use within each Health Board.
The following can be utilised by members of the community pharmacy team to help support patients and carers.
What Matters Conversations - Provides resources to support starting “what matters” conversations with patients and carers.
The Carer Support Needs Assessment Tool Intervention (CSNAT-I) can be utilised to support carers to identify areas they may require support with, tailoring support specifically to their individual needs.
The Your Medicines Your Health campaign aims to promote safe medicines management and has resources available to support patients and carers with medications.
AWTTC have developed a Patient Information Guide on Opioids in Palliative Care, this can be used to support answering questions patients or carers may have regarding the use of opioids in palliative care. This information guide is available bilingually.
Yellow Card Centre Wales is one of six regional adverse drug reaction monitoring centres, acting on behalf of the MHRA, and provide resources to support patients and healthcare professionals to report adverse effects of medicines and vaccines.
The following organisations and resources can be used for signposting patients and carers with different aspects including end of life care and bereavement.
Marie Curie have developed the Daffodil Standards in partnership with the RPS. Marie Curie is a charity providing hospice care and information and support about dying, death and bereavement. Resources covering a range of topics can be downloaded or ordered from their website. Marie Curie also provides the Wales Bereavement Information and Support Service (BISS) in partnership with Diverse Cymru, this can be accessed via the Marie Curie website.
The following document has been developed as part of the Daffodil Standards and can be used to support patients and carers to identify and record key local contacts who may support them.
Carers UK provide expert information and guidance for unpaid carers.
Carers Trust provide advice and support for unpaid carers.
Macmillan Cancer Support, support people living with cancer and their family, friends, and carers. Information resources are available in a variety of formats for example booklets, audiobooks and blogs on their website.
Hospice UK provide practical advice guides and resources on hospice care and bereavement.
Hospice UK have a Dying Matters Campaign with leaflets available that can be downloaded providing information on different aspects of dying, death and bereavement.
Cruse provides information and bereavement support which can be accessed via their website and the bereavement support national helpline.
Maggie’s have two centres in Wales, in Swansea and Cardiff, where people with cancer and their loved ones can receive specialist support including bereavement support. Information about cancer, diagnosis and treatment is available from the Maggie’s website.
Compassionate Cymru works with individuals, organisations, and communities to improve how people in Wales care, die and grieve. Information and support including signposting recommendations for support with advanced care planning, palliative care, and bereavement are available via the Compassionate Cymru website.
Care for the Family are a charity providing support in key areas of family life, with resources available on their website to support with bereavement.
The Good Grief Trust helps those affected by grief and brings bereavement services together in one place to ensure bereaved individuals can access support.
At a Loss is an information portal that can be used to find local and national organisations and services to signpost bereaved individuals to.
DEWIS Cymru is an information portal that can be used to find local and national organisations and services to signpost individuals to for help with their wellbeing.
Tell Us Once is a service that enables individuals to report a death to most government organisations in one go.
Next page content review due: July 2026