These guidelines are not meant to replace the many available texts on the subject of palliative care. They are a summary of the current practice of specialists working in palliative care in the West Midlands Region.

These guidelines can be used for patients who are receiving care at home, or in hospitals, and should meet the needs of most patients. The medical and nursing staff of your local Specialist Palliative Care Team are available if further advice is required.

Some of the management strategies describe the use of drugs outside their licensed indications. They are, however, established and accepted good practice.

The drug information in this guideline is not exhaustive. Please refer to the current BNF for guidance.

The production of these guidelines remains independent, funded by the sales of previous editions. No external funding has been received. The guidelines have the approval of the West Midlands Palliative Care Physicians.