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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Community Palliative Care Team - based at Meadow House Hospice
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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)

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