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Who is Community Specialist Palliative Care Service for?

Community Specialist Palliative care (care that relieves pain, symptoms and stress caused by serious illnesses) is for adults aged 18 or over who are registered with a Harrow GP.

The service supports adults with advanced progressive illness, life expectancy of one year or less and in addition:

  • Severe and/or complex symptoms that are difficult to control
  • Complex psychosocial issues for the patient or family/carer
  • Complex end of life issues and advanced care planning

What does the service provide?

The purpose of the team is to empower people with advanced and progressive illnesses (and people who support them) to maximise their individual quality of life and death by enabling the provision of skilled palliative care. This includes:

  • Provision of specialist clinical advice on palliative care issues to patients, their families/carers and those who care for them.
  • Specialist advice and support to help patients and their families/carers cope with the emotional impact of living with advanced progressive illnesses and end of life. This includes psychological support.
  • Provision of a case management service for patients and their families/carers with complex needs liaising closely with other services involved in their care.
  • Provision of high quality information to enable informed choice about treatment options and end of life care, including advanced care planning decision making.
  • Empowering health and social care professionals to provide high standards of care to palliative patients in accordance with national guidance, by joint working and provision of education and training.

The team practises four levels of intervention.

  • Level 1: Advice, information and support may be accessed directly from a member of the team by a professional who is making the referral. No contact with the patient will be made.
  • Level 2: A single consultation visit or outpatient appointment for advice.
  • Level 3: Short term interventions by a team member to address specific problems. The intention is to discharge from the service with open access to re-referral if required.
  • Level 4: Longer term involvement for individuals who have complex on-going problems.

How do I access the service?

Referrals are accepted from all healthcare and social care professionals, patients and relatives. If calls are received direct from patients/relatives, they are in the first instance requested to contact the patient’s GP to request a written referral to be provided.

Referrals are accepted Monday to Friday in writing on a completed London Cancer Alliance (LCA) Specialist Palliative Care referral form, with relevant clinical information attached.

Patients should consent to the referral prior to the referral being sent.
Referrals are prioritised on a daily basis according to need by a clinical nurse specialist.

For non-urgent referrals, patients will be contacted within the following specified time frames with appointment:

  • Patient with uncontrolled symptom, severe anxiety, and/or emotional distress will be contacted within three working days of receipt of complete referral.
  • Patient with controlled symptoms that require advanced care planning, carer support, and/or general supportive care will be contacted within five working days of receipt of complete referral.

For urgent referrals patients should have:

  • Severe complex uncontrolled symptoms
  • Prognosis of days or less
  • Discharged home from hospital to die

These patients will be contacted by telephone on the day of referral if received before 1pm or next working day if after. They will be seen within two working days of receipt of a complete referral.

The service is available from Monday to Friday, 8.30am to 4.30pm.
For out-of-hours telephone advice please contact Michael Sobell House, on 01923 844281
The service is provided by London North West Healthcare NHS Trust (LNWHT).

For further information about the service visit LNWH Palliative care service