It's important you assess the patient's needs and confirm consent before any referral to Pilgrims Hospices. 

The information you give us about an individual, and their family or carer situation, is key to ensure we work with you to provide joined up care.

The more detailed the information you can give us from your assessment, the better care we can offer and the smoother the patient’s journey.

It can be helpful if you start the discussion about ceilings of treatment and future care preferences as early as appropriate too, including considering a do not attempt CPR form.

We also recommend that you put 'just in case' medicines in place which can be given by injection – our community prescription sheet makes suggestions for relevant medications and doses.

Please note that patient consent must be obtained before making a referral, or a decision made in line with the Mental Capacity Act if the patient lacks capacity. This is vital when making a referral and referral forms will be returned if this has not been completed.

Referrals are welcomed from consultants, GPs, clinical nurse specialists, district nurses and community matrons.

If the GP is not the referrer, please advise the patient’s GP of your referral.

There is evidence that early referral to specialist palliative care services will help quality of life in terminal patients. Any of the following should prompt an early referral:

• High symptom burden
• Poor engagement with Advance Care Planning
• Carer strain related to palliative illness
• Difficult family dynamic
• Self-perceived burden
• Patient and carer mismatch of ideas and beliefs
• High levels of service use
• Limited opportunity for adjustment e.g. late diagnosis or sudden and rapid rate of decline
• Social isolation or low levels of support
• Past poor experience of a loved one's death
• Risk factors for poor bereavement outcome for family or carers eg risk of traumatic death; difficult or ambivalent relationship between carer and patient; situation where carer needs to cease employment to perform caring role
• High psychological symptom burden for patient or carer

Depending on the reason for referral, an appropriate member of our team will make contact with the patient and agree an appointment time. 

This may be a clinic appointment (an appointment at the patient’s local hospice with an appropriate member of the professional hospice team – not unlike a GP appointment) or a community visit.

If the referral is urgent, a member of the team will make telephone contact within two working days.

For immediate advice and guidance, healthcare professionals may phone their local hospice direct.

Our 24 hour telephone line is available to give you advice. Pilgrims does not have the facilities or resources to respond to emergencies in the community.

It is important to encourage patients and their families or carers think ahead.

Planning ahead means having important discussions about issues such as resuscitation or emergency treatment in hospital.

Talking about where someone wants to be cared for when they are dying or when they are less able to care for themselves may seem difficult, but will make life easier for you and those around you in the event of an emergency.

No we are keen to see patients and their families with all diseases with a palliative phase that might need our services.

Some patients just need specific elements, for example advance care planning or anxiety management. This is fine. Most of the Wellbeing and Social Programmes held in Pilgrims Therapy Centres are time-limited. They can be accessed individually or in succession depending on your patient's needs.

Please indicate which programme your patient needs to attend, or the symptom they need support with, on the referral form and you will be informed when they have completed this programme.