Referral form

Healthcare Professionals play a vital role in helping set patient's expectations of modern hospice care. The care we deliver for patients is always centred around their individual needs. This is delivered by working in partnership with GPs, Community Nursing Teams, District Nurses, local Pharmacists to name a few. GPs remain in charge of the patient’s care whilst they are in the community. 

We welcome referrals for patients at all stages of their illness, including early stages where appropriate, so that we can support them, and those important to them for as long as required. We are happy to discuss any uncertainties you may have regarding whether or not to refer or if you need help signposting to other services.

Advice for professionals from senior medical and nursing staff is available 24 hours a day. 020 8099 7777

Who can refer?

Referrals need to be made by a Healthcare Professional - if you are reading this as a patient or carer, and wish to be referred to the Hospice, please contact your GP to discuss further.

How to refer

Please complete a pan London Specialist Palliative Care Referral Form below and indicate urgency. All referrals should be emailed to [email protected] using a secure email account such as NHS email.

Referral form

If the referral is urgent (patient needs to be seen within 2 days) please contact us on 020 8099 7777 to discuss.

Our Hospice Point of Contact (HPoC) team assesses all referrals. Out of hours referrals are assessed by our nursing and medical teams. We respond according to the need, urgency and complexity of the issues presented to us by the referrer.
This depends on the amount and quality of information received: incomplete referral forms will cause delays as we chase this essential information.

Checking questions:

• Has the patient consented to the referral? We are unable to action a referral if it has not been discussed with the patient and consent gained (or their next of kin if they lack capacity)
• Does the patient live in Sutton or Merton and is the GP registered in Sutton or Merton? (NB we cover a small group of patients with GP's in Wandsworth but who live in Sutton and Merton). Occasionally, we can accept a patient for end-of-life care onto our IPU who live out of the area on compassionate grounds. Please ring and speak to the team if you wish to discuss this
• Does the patient have a level of need that requires additional support to pre-existing primary or secondary care?
• Are there reasons for referral based on the needs of the patient and those important to them rather than just the diagnosis?
• Are all areas of the referral form completed? If an area is non-applicable, please state 'N/A'
  We are unable to action a referral if is not complete
• Are you able send a copy of the latest scan, clinic letters, blood results and EMIS summary where possible?

Examples of reasons for referral are:

• Progressive and life-limiting malignant or non-malignant disease where the complexity of the illness requires the services of a specialist palliative care team
• Difficult pain and symptom control 
• Patients and those important to them having difficulty in coping with the progressive illness and its consequences
• Complex spiritual issues due to the impact of the illness on spirituality

What to do next:

• Update the patient's Urgent Care Plan (UCP) including ceiling of care and DNACPR status where possible
• Coordinate referrals for additional support where necessary e.g social care packages/district nursing services
• Anticipatory prescribing for end-of-life guidance can be found here

For the current COVID-19 restrictions, please see Guidance on visiting the Hospice.