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Background The Community Palliative Care Team at Phyllis Tuckwell regularly provides anticipatory prescribing recommendations for patients approaching end of life. These are typically communicated to the patient’s GP. The NICE Quality Standard 144 (National Institute for Health and Care Excellence. Quality statement 3: Anticipatory prescribing. In: Care of dying adults in the last days of life. [QS144], NICE; 2017) outlines key factors clinicians should consider when recommending such prescriptions, including symptom likelihood, clinical risks, medication benefits, and accessibility based on the care setting.Aim To assess whether Phyllis Tuckwell’s anticipatory prescribing recommendations align with NICE, PCF8 (Wilcock, Howard, Charlesworth, (eds.) Palliative Care Formulary. 8th ed. London: Pharmaceutical Press; 2022), and the hospice’s prescribing guidelines.Objectives To evaluate adherence to the Phyllis Tuckwell guidance on opioid prescribing.Assess prescribing in the context of renal/hepatic impairment.Review prescribing considerations for patients with Parkinson’s/Lewy Body Dementia.Methodology A retrospective review was conducted of all patients under Phyllis Tuckwell’s community care who died between 1 February and 31 March 2024, using EMIS data. Key data included GP surgery, date of death, timing of recommendations, and clinical appropriateness of medications (opioids, antiemetics, sedatives, anti-secretory agents), especially in patients with renal/hepatic impairment.Results 169 patients reviewed, of which 51 had anticipatory guidance sent to their GP.Average time from recommendation to death: 34.6 days.100% included appropriate PRN dosing.94.1% adhered to opioid guidelines.92.3% compliance with renal guidance; 100% with hepatic guidance.100% compliance in the use of cyclizine for nausea and vomiting in patients with Parkinson’s Disease/Lewy Body Dementia.Conclusion Phyllis Tuckwell’s anticipatory prescribing recommendations are largely compliant with national and local guidelines, demonstrating strong clinical awareness. Improvements could be made in aligning timing of recommendations and further refining use of creatinine clearance for safer prescribing in renal impairment.