Updated palliative care referral form version 4.2

What's changed

The specialist palliative care teams across North West London now work together to redirect referrals between providers rather than sending them back to the GP. Once you submit a referral, it becomes the responsibility of the receiving team to find the best service for the patient based on their needs, provided the patient meets the core criteria for specialist palliative care.

How it works

Complete the pan-London referral form and send it using the contact details provided. The receiving team will triage, redirect if needed, and coordinate services - including arranging multiple providers if required.

What services does this cover?

Services include community specialist palliative care teams, 24/7 advice lines, hospice at home, inpatient units, outpatient clinics, lymphoedema services, and psychological and bereavement support.

Eligibility

  • Living in NWL and registered with an NWL GP
  • aged 18+
  • Advanced, progressive, life-limiting illness (including cancer, frailty, organ failure, neurological conditions, dementia)
  • Complex symptoms or circumstances requiring specialist palliative care input 
  • Patient consent obtained or best interest decision made

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Related Services

Hospices

Community Palliative Care Team - based at Meadow House Hospice
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Community Palliative Care Team - based at Meadow House Hospice

T. 020 8967 5179

W. https://www.lnwh.nhs.uk/meadow-house-hospice/#community-palliative-care-team

The Community Specialist Palliative Care Nurse Team provides advice and visiting to palliative care patients in Ealing and Hounslow. The team are based at Meadow House Hospice.

The team will visit patients with progressive life limiting illness in their own homes. They provide specialist advice around pain and symptom control and support for patients, their families, and carers during the last stages of illness. They also support patients wishing to die at home through coordination with GPs and hospital teams.

The team is comprised of medical consultants, specialist nurses, physiotherapists, occupational therapists, social workers, a bereavement support officer and a patient and carer advocacy worker

The team can be contacted for referrals Monday to Friday 9.00am to 5.00pm.

Between Monday to Friday 5.00pm and 8.30am, the Out of Hours Telephone Advice line 020 8102 5000 takes calls. Weekends and Bank Holidays 5.00pm to 9.00am.

Referral form for clinician use only.

Community Specialist Palliative Care Referral Form V4.2 (DOCX)
Hospice UK
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Hospice UK can help find a hospice, provide infromation and support about end of life care and guidance to plan ahead.

Meadow House Hospice Inpatient Unit
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Meadow House Hospice Inpatient Unit

T. 0208 967 5179

W. http://meadowhouse.lnwh.nhs.uk

Meadow House Hospice provides inpatient palliative care services to the residents of Ealing.

The hospice has a 15 bedded inpatient unit supported by a team of dedicated staff providing 24/7 specialist support to patients and their family members. Patients with a progressive life limiting illness can be admitted for symptom management or end of life care.

Patients have a safe, dignified space of their own and the flexibility to spend time alone or in company, surrounded by their possessions and the people they care about. The hospice also has an extensive garden area that provides a quiet and reflective environment for both patients and family members.

Please contact the hospice Monday to Friday 8.30am to 4.30pm and during the weekend 9.00am to 5.00pm on 0208 242 5817.

There is a 24 hour telephone support line to the hospice ward on 0208 967 5597.

Bereavement services to support family members, friends and carers connected to a loved one who was cared for by the Hospice, can be contacted via main switchboard.  

Referral form for clinician use only.

Community Specialist Palliative Care Referral Form V4.2 (DOCX)

Palliative care teams

Community Palliative Care Team - based at Meadow House Hospice
Close

Community Palliative Care Team - based at Meadow House Hospice

T. 020 8967 5179

W. https://www.lnwh.nhs.uk/meadow-house-hospice/#community-palliative-care-team

The Community Specialist Palliative Care Nurse Team provides advice and visiting to palliative care patients in Ealing and Hounslow. The team are based at Meadow House Hospice.

The team will visit patients with progressive life limiting illness in their own homes. They provide specialist advice around pain and symptom control and support for patients, their families, and carers during the last stages of illness. They also support patients wishing to die at home through coordination with GPs and hospital teams.

The team is comprised of medical consultants, specialist nurses, physiotherapists, occupational therapists, social workers, a bereavement support officer and a patient and carer advocacy worker

The team can be contacted for referrals Monday to Friday 9.00am to 5.00pm.

Between Monday to Friday 5.00pm and 8.30am, the Out of Hours Telephone Advice line 020 8102 5000 takes calls. Weekends and Bank Holidays 5.00pm to 9.00am.

Referral form for clinician use only.

Community Specialist Palliative Care Referral Form V4.2 (DOCX)
District Nurses Ealing
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The District Nurses are based at Featherstone Road Health Centre, Acton Health Centre and Greenford Green Clinic.

Referrals can be made Monday to Sunday 8.00am to 8.00pm.

The Rapid Response District Nurse team are based at Clayponds Hospital and referrals can be made Monday to Sunday 8.00am to 12.00pm.

Meadow House Hospice Inpatient Unit
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Meadow House Hospice Inpatient Unit

T. 0208 967 5179

W. http://meadowhouse.lnwh.nhs.uk

Meadow House Hospice provides inpatient palliative care services to the residents of Ealing.

The hospice has a 15 bedded inpatient unit supported by a team of dedicated staff providing 24/7 specialist support to patients and their family members. Patients with a progressive life limiting illness can be admitted for symptom management or end of life care.

Patients have a safe, dignified space of their own and the flexibility to spend time alone or in company, surrounded by their possessions and the people they care about. The hospice also has an extensive garden area that provides a quiet and reflective environment for both patients and family members.

Please contact the hospice Monday to Friday 8.30am to 4.30pm and during the weekend 9.00am to 5.00pm on 0208 242 5817.

There is a 24 hour telephone support line to the hospice ward on 0208 967 5597.

Bereavement services to support family members, friends and carers connected to a loved one who was cared for by the Hospice, can be contacted via main switchboard.  

Referral form for clinician use only.

Community Specialist Palliative Care Referral Form V4.2 (DOCX)
Planned Night End of Life Care
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Planned Night End of Life Care

T. 0203 370 2208

This is an overnight service and is provided by Marie Curie via Meadow House Hospice for residents of Ealing and Hounslow. This service provides one to one overnight nursing support, symptom control, management of pain, emotional and practical support for patients in their last few weeks of life.

Referrals are made via Local Clinical Coordination Centre Monday to Sunday from 10.00pm to 7.00am.

Marie Curie Planned Night Services Referral Form (DOCX)

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