asked Her Majesty's Government:How many people in National Health Service hospitals who died in each of the last five years as "Do not Resuscitate" patients were being prescribed diamorphine when they died; for how long in each case the drug had been prescribed; and, if they do not currently have the figures, whether they will ask each National Health Service trust to provide them with as much information as they have available. [HL375]
Information on the prescribing of diamorphine in National Health Service hospitals to individual patients is not collected locally or nationally. Most records of prescribing and administration of medicines in hospitals are held on paper. The information requested is only available from individual patients' case notes. Collecting and analysing this information would require examination of the notes of all patients who died in NHS hospitals in the last five years.Clinical governance arrangements, introduced in March 1999, provide a clear and comprehensive framework of measures to assure and improve the quality of clinical care delivered to all NHS patients.In June 1998 the Department of Health endorsed and distributed throughout the National Health Service two documents of good practice in palliative care, produced by the National Council for Hospices and Specialist Palliative Care Services. One of these documents was
Guidelines for Managing Cancer Pain in Adults, which was designed for use by health professionals in primary care and institutional settings and includes guidance on dosages of diamorphine for terminally ill patients. The Other, Changing Gear— Guidelines for Managing the Last Days of Life in Adults, as the title suggests, refers to the care needed when death is imminent. Copies are available in the Library.