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Sirona SPA for community services, and Sirona drug/ medication authorisation charts

Updated on 17th July 2026

Sirona: one number, many services

Since 1 April 2020, there has been one number for accessing adult community NHS health services across Bristol, North Somerset and South Gloucestershire.

Single Point of Access
0300 125 6789
For adult community NHS health services across Bristol, North Somerset and South Gloucestershire.
  • Clinicians can use this number to refer people into community health services, regardless of where they live within the area.
  • This includes urgent GP referrals requiring a response within two hours.
  • Patients and their representatives can also use the number as a Single Point of Access.

Medication authorisation charts

In Integrated Urgent Care (IUC), the following forms may be needed to support community teams to administer medicines, including District Nursing and Locality Acute and Reactive Care (LARC) teams.

Before completing a form

  • Forms can be completed electronically and emailed. They do not need a physical signature.
  • Always include your professional registration details, such as your GMC or NMC number.
  • The forms cannot be uploaded to EMIS.

Submitting completed forms

  1. Email the completed form to the SevernSide referral account: severnside.referral@nhs.net.
  2. Send an instant message to the shift manager to confirm that you have submitted it.
  3. The shift manager will forward the email or referral to sirona.psd@nhs.net on your behalf.

This process ensures that SevernSide can manage any replies or queries, including those received after you have finished your shift.

End-of-life medications

Chart update: an updated end-of-life chart was introduced on 1 March 2023.

Summary of changes

  1. Patients with a longer prognosis: when a CPC drug chart is being used for symptom control for a palliative care patient with a prognosis longer than weeks or days, tick the new non end of life symptom control box on the front of the chart. Do not authorise other syringe-pump medicines for the last days of life, such as midazolam marked start when needed.
  2. Superseded charts: to avoid confusion where there are multiple CPC drug charts in the home, a non-prescribing community clinician can discontinue an old chart. Draw a line through the front and add the word superseded and the date.
  3. Syringe-pump starting doses: only give a starting dose when the syringe pump is being set up immediately. When it may be needed within the next few days, select Start when needed.
  4. Possible dose adjustments: where the clinically relevant risk of side effects outweighs the risk of suboptimal symptom control, consider adjusting the doses of some JiC medicines. Refer to the Community palliative care prescribing table: symptom control in the last days of life for adults on the back page of the Anticipatory Prescribing Chart. This may apply to patients with:
    • renal failure with eGFR < 30 ml/min/1.73 m2;
    • severe liver impairment, classified as Charles-Pugh score C, such as advanced cirrhosis or liver failure; or
    • severe frailty and/or low body mass index. Use clinical judgement.
  5. Respiratory or gastrointestinal secretions and colic: hyoscine butylbromide remains the first-line injectable medicine. Glycopyrronium is now the second-line medicine and should be prescribed when cyclizine is being used as an antiemetic, because hyoscine butylbromide is not compatible with cyclizine in a syringe pump. Glycopyrronium has been added to the list of medicines stocked by pharmacies with a specialised medicines contract.

Further clinical guidance

View the St Peter’s Hospice clinical guidelines. The page includes an updated quick-reference guide with essential clinical guidance, changes and safety tips, as well as the full anticipatory prescribing policy for the Integrated Care Board.

End-of-life night sitters

Night sitters may be available following a District Nursing assessment, with the team contacting Marie Curie, or through St Peter’s Hospice.

Community Anticipatory Prescribing form (non-Covid)

BNSSG Anticipatory Prescribing Form V9.1 Blank - Non-EMIS Version

Amending an end-of-life chart in EMIS

  1. Find the most recent chart in the patient’s EMIS documents.
  2. Select Save as and save the chart in the patient forms folder. See guidance on finding this folder at different treatment centres.
  3. Open the folder where the chart was saved, then open the document.
  4. Edit and save the chart.
  5. Complete your details on the front page.

Follow the submission process above after completing the chart.

Non-end-of-life medications

Chart update: since April 2022, the same community prescribing charts can be used across all areas of Bristol, North Somerset and South Gloucestershire (BNSSG). These forms can be completed remotely and emailed to Sirona.

Follow the submission process above after completing the chart.

Clevedon Community Hospital inpatient ward

An electronic drug chart cannot be completed for an inpatient at Clevedon Community Hospital.

Patients who need a drug chart require a home visit so that a paper chart can be completed by hand.

Urgent Community Response

Sirona care & health has reorganised its adult services to support the Out of Hospital Model. The referral route has not changed.

Core hours8 am to 8 pm, seven days a week
Urgent responseWithin two hours for eligible people
LocationIn the person’s home, including care homes
ReferralBy a GP or other healthcare professional

Integrated Network Teams

Integrated Network Teams (INTs) work closely with clinicians through multidisciplinary team working and align with Primary Care Networks (PCNs). They provide coordinated, wraparound care that helps people remain in their own homes, including care homes, as independently as possible.

The teams include:

  • community nurses and therapists;
  • paramedics and advanced clinical practitioners;
  • support workers and community pharmacists; and
  • administrative colleagues.

The service supports people who need planned or unplanned care, as well as rehabilitation following discharge through Discharge to Assess Pathway 1.

Overnight support: the Out of Hours service continues to support people already on the caseload who need urgent treatment overnight, including palliative support and help with catheter blockages.

Locality Acute and Reactive Care

Urgent care services previously coordinated through Rapid Response now form the domiciliary Locality Acute and Reactive Care (LARC) service. Advanced Clinical Practitioners in Urgent Care support the service.

LARC aims to prevent avoidable hospital admissions and help people recover as close to home as possible. It forms part of Sirona’s urgent care offer and works alongside the Integrated Network Teams.

Eligible people can receive a two-hour domiciliary response between 8 am and 8 pm, seven days a week. This provides a consistent response time across Bristol, North Somerset and South Gloucestershire.

Many people using the service have complex needs. The team can provide rapid assessment, diagnosis, treatment where needed and onward care planning. As part of the Same Day Urgent Care offer, the service aims to stabilise the person’s condition, prevent unnecessary hospital admission and enable them to remain close to home.

Working with other services

LARC and the Integrated Network Teams work closely with Specialist Advice and Support Services (SASS), local authorities, primary care, voluntary sector organisations and other community health and care providers.

Referral and follow-up

  1. A GP or other healthcare professional refers the person for an assessment at home.
  2. The service completes the assessment and provides diagnosis and treatment where needed.
  3. The Integrated Network Team provides ongoing monitoring, care and support, or arranges hospital admission when required.
  4. For people with complex needs, multidisciplinary team meetings coordinate care across health and social care services within the locality.

View the Urgent Community Response eligibility criteria on Remedy.

Prescribing for prison residents

This applies when prescribing through the Electronic Prescription Service (EPS), with dispensing from prison or SevernSide stocks.

Prison Oxleas Medication Authorisation Chart
HMP Bristol Required to enable medicine administration
HMP Ashfield Required to enable medicine administration
HMP Leyhill Not required

Further information

Search terms: drug chart, community, prescribing, end of life, electronic.

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