How to refer

Information and guidance on how to refer patients to St Christopher's

Clinicians may refer using the form below or by phoning 020 8768 4582 (9am to 5pm Monday to Friday) or 020 8768 4500 (24 hours). Please telephone for all emergency referrals.

Downloads

• All age Pan-London Specialist Palliative Care Referral form for completing digitally and emailed via NHS Mail (Word)
• All age Pan-London Specialist Palliative Care Referral form (PDF)

Once completed please email to st.christophers@nhs.net.

Please make sure that you send this form using a secure email account such as NHS email.

All referrals to St Christophers will require the following information to be completed with the following:

ESSENTIAL CRITERIA:

• Referrer’s name and contact details
• Demographics (Essential Patient Details)
• GP Details (Name/Surgery Address)
• Consent (Has this referral been discussed with the patient?)
• Reason for referral
• Further details of current palliative care problems
• Primary Diagnosis
• Brief history of Diagnosis(es)/key treatments
• Other Past Medical and Psychiatric history

In line with the Mental Capacity Act 2005 and its Code of Practice, St Christopher’s Hospice operates on the principle that every individual is presumed to have capacity to make their own decisions. However, if there is reason to question a person’s capacity to consent to admission, a mental capacity assessment must be carried out by the referring professional(s).

If the individual is assessed as lacking the capacity to make this decision, a best interests decision must then be made in accordance with the Mental Capacity Act 2005, following the checklist outlined in section 5.13 of the Code of Practice.

To enable our team to determine whether St Christopher’s is the most appropriate service and to ensure we can safely meet the individual’s needs, our Admissions Team requires evidence of both the mental capacity assessment and the best interests documentation. This information supports our ability to make an informed decision regarding admission and to develop a person-centred care plan that is in the individual’s best interests from the moment of arrival.

Where a person lacks capacity to consent to admission and has no Lasting Power of Attorney (Health and Welfare), Court-Appointed Deputy, or family and friends to act on their behalf, the involvement of an Independent Mental Capacity Advocate (IMCA) may be required to safeguard their rights and ensure their voice is represented throughout the process.

Please note that St Christopher’s Hospice does not provide respite care and is not a place of safety in safeguarding situations. Our expertise lies in symptom control, pain management, and end-of-life care for individuals with complex needs that cannot be met at home.

DESIRABLE CRITERIA:

• Prognosis
• Allergies
• NHS number
• Protected characteristics (Ethnicity, Sexual orientation, Gender, Disability)
• NOK / main contact
• Up to date medication list

Please note:

• If any of the essential criteria boxes on the form are left blank or state “see attached” our admin team will return this and request that the form be completed to our minimum requirements
• If any of the desirable criteria boxes on the form are left blank – we shall process the referral but also write back and request that you send this information to us
• The form WILL NOT be reviewed by a clinical member of the team before it is returned
• Please do not cut and paste from hospital records and please summarise on the referral form any attached information

If you would like to integrate our referral form into your electronic patient record system, please email communications@stchristophers.org.uk

We welcome discussion with community or hospital colleagues about cases where they need urgent advice, are uncertain whether to refer or need help signposting to other services. Advice for professionals from senior medical and nursing staff is available 24 hours a day (020 8768 4500). Anticipatory prescribing for end of life guidance can be found here.