№ lp_2_3_19026
File format: docx
Character count: 12446
File size: 112 KB
This is a referral form used by healthcare providers in London to request specialist palliative care services for patients, including personal and medical details, consent information, and specific care requirements.
Year:
2024
Region / City:
London
Subject:
Palliative Care
Document Type:
Referral Form
Organization:
Pan-London Specialist Palliative Care Network
Author:
Not specified
Target Audience:
Healthcare professionals, caregivers
Period of Validity:
Ongoing review
Approval Date:
10/04/24
Review Date:
10/04/26
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Version:
1.0
Circulated date:
January 2024
Review date:
July 2024
Scope:
Children and young people with Type 1 diabetes (CYP with T1DM)
Guideline reference:
NICE NG18 (2022)
Type:
Implementation document
Region:
London
Target audience:
Paediatric diabetes teams, healthcare professionals, CYP with T1DM and their families
Components:
Written pathway, implementation flowchart, accompanying device list
Device focus:
Continuous glucose monitoring (CGM)
Purpose:
Support implementation of NG18 and guide device choice
Version:
5
Agreed Date:
16/10/2024
Review Date:
16/10/2026
Geographic Scope:
Pan-London
Healthcare Setting:
Community setting
Clinical Area:
Palliative care
Document Type:
Medication authorisation and administration record
Medication Routes:
Subcutaneous injection; Intramuscular injection; Continuous subcutaneous infusion
Medication Use:
As required (PRN); Regular dosing; Crisis and emergency use
Patient Population:
Community patients receiving injectable symptom control medication
Responsible Professionals:
Authorising clinicians (GMC/NMC/GPhC registered)
Associated System:
NHS
Content Sections:
PRN injection charts; syringe pump authorisation charts; crisis and emergency injection records; regular dose injection records; controlled drug stock balance charts
Review Statement:
Subject to ongoing review to reflect emerging evidence
Year:
2024
Region / City:
London
Theme:
Palliative Care
Document Type:
Referral Form
Organization:
Health Service
Author:
N/A
Target Audience:
Healthcare Professionals
Period of Validity:
Ongoing review
Approval Date:
10/04/24
Review Date:
10/04/26
Year:
2026
Region / City:
London
Topic:
Continuing Health Care (CHC)
Document Type:
Care Plan
Author:
NHS
Target Audience:
Healthcare professionals, Social care providers
Action Period:
Ongoing review and updates
Approval Date:
16/10/2026
Review Date:
16/10/2026
Discipline:
Nursing
Simulation Type:
Clinical simulation
Simulation Level:
Student
Expected Simulation Run Time:
20–30 minutes
Setting:
Home
Patient Age:
65
Primary Medical Diagnosis:
Stage IV lung adenocarcinoma
Past Medical History:
Lung adenocarcinoma treated with radiation and chemotherapy
Social Context:
Retired, lives with long-term partner
Care Focus:
Hospice and palliative care
Learning Focus:
Assessment of older adults, caregiver preparedness, advance directives
Participants Roles:
Nurses, provider, family members, observers
Simulation Modality:
Simulated patient
Educational Frameworks Referenced:
ACE.S Framework, SPICES, Katz Index of Independence in Activities of Daily Living
Source Type:
Educational simulation design document
Job title:
Palliative Care Social Worker
Department:
Family Support
Organisation:
Prospect Hospice
Location:
Swindon, Marlborough and northeast Wiltshire
Hours:
30 hours per week
Reports to:
Clinical Lead
Type of document:
Job description
Sector:
Palliative and end-of-life care
Team:
Family Support Team
Scope of role:
Patient, family and bereavement support
Responsibilities:
Psychosocial assessment, advocacy, multidisciplinary collaboration, safeguarding
Target group:
Patients with life-limiting illness and their families
Year:
2022
Region / City:
Louisville, KY
Theme:
Palliative and Hospice Social Work Certification
Document Type:
Candidate Handbook
Organization / Institution:
APHSW Certification Board
Author:
APHSW Certification Board
Target Audience:
Social workers interested in obtaining APHSW-C certification
Period of validity:
Four years
Approval Date:
January 2022
Date of amendments:
N/A
Year:
2021
Region / city:
Canberra
Topic:
Subcutaneous Medication Administration in Palliative Care
Document Type:
Procedure
Organization / institution:
Canberra Health Services
Author:
Canberra Health Services
Target audience:
Healthcare professionals, specifically nursing staff in palliative care settings
Period of validity:
Ongoing
Approval Date:
2021
Amendment Date:
Not specified
Year:
2025
Region / City:
Leicestershire and Rutland
Topic:
Healthcare, Palliative and End of Life Care
Document Type:
Official Request for Information
Organization:
Leicester, Leicestershire and Rutland Integrated Care Board (ICB)
Author:
Corporate Governance Team
Target Audience:
Healthcare professionals, ICS stakeholders
Period of Operation:
Ongoing, 24/7
Approval Date:
January 2025
Modification Date:
January 2025
Year:
2025
Region / City:
Dublin, Ireland
Field:
Healthcare
Document Type:
Job Description
Organization:
Health Service Executive (HSE)
Author:
Not specified
Target Audience:
Healthcare professionals, nursing staff
Period of Validity:
2 years
Approval Date:
Not specified
Modification Date:
Not specified
Year:
2024
Region / city:
Leicester, Leicestershire and Rutland
Topic:
Palliative and End of Life Care
Document Type:
Report
Organization / Institution:
NHS Leicester, Leicestershire and Rutland Integrated Care Board
Author:
Kirstie Swinfield
Target Audience:
Local residents and stakeholders
Period of Application:
2024/25 – 2028/29
Approval Date:
November 2024
Date of Changes:
N/A
Note:
Year
Theme:
Palliative care
Document Type:
Medical guideline
Institution:
Severn Hospice
Target Audience:
Healthcare professionals
Year:
2016
Note:
Region / City
Topic:
Palliative care, referral process
Document Type:
Referral form
Target Audience:
Healthcare professionals, care providers
Approval Date:
June 2016
Year:
2019
Region / City:
Gloucestershire
Theme:
Palliative and End of Life Care
Document Type:
Service Specification
Organization / Institution:
NHS Gloucestershire Clinical Commissioning Group
Author:
Marion Andrews-Evans
Target Audience:
Healthcare Providers, Pharmacists, GP Practitioners
Effective Period:
1 April 2019 to 31 March 2020
Review Date:
January 2020
Year:
2024
Region / City:
London
Theme:
Palliative Care
Document Type:
Referral Form
Organization:
Health Service
Author:
N/A
Target Audience:
Healthcare Professionals
Period of Validity:
Ongoing review
Approval Date:
10/04/24
Review Date:
10/04/26
Note:
Year
Region / City:
London
Topic:
Palliative Care, Medical Referral
Document Type:
Referral Form
Organization:
London Home Palliative Care Team
Author:
Dr. Kirk Hamilton
Target Audience:
Healthcare professionals, Patients, Caregivers
Description:
Referral form for patients requiring home-based palliative care services.
Year:
2026
Region / city:
Dorset, Wiltshire
Subject:
Palliative care referral
Document type:
Referral form
Author:
Not specified
Target audience:
Healthcare professionals, families
Period of validity:
Not specified
Approval date:
Not specified
Date of amendments:
Not specified
Context:
Referral form for healthcare professionals to request palliative care services for children with life-limiting or life-threatening conditions.
Year:
2026
Region / District:
Adjumani and Obongi, Uganda
Topic:
Palliative care, community health, refugee health
Document type:
Research abstract
Institution / Organization:
Makerere University, Palliative Care Education and Research Consortium, Peace Hospice Adjumani, Cairdeas International Palliative Care Trust, International Children’s Palliative Care Network, Global Health Academy University of Edinburgh, St. Columbus Hospice
Authors:
Vicky Opia, Elizabeth Nabirye, Elizabeth Namukwaya, Janice Logan, Chris Smith, Godfrey Toko Friday Santiago, Liz Grant, Julia Downing, Kate Howorth, Kathleen McGeough, Michelle McGannan, Mhoira Leng
Target population:
Village Health Teams and family caregivers in refugee settlements and host communities
Methodology:
Training and mentorship of 100 VHTs, 22 completed mentorship course, training of 300 family caregivers, use of smartphones, community sensitization via radio shows, qualitative and quantitative data collection
Results summary:
Improved self-confidence of VHTs, increased identification and referral of palliative care patients, 27,141 patients/families accessed services
Lessons learned:
Community engagement, training alongside mentorship, and stakeholder support improve palliative care delivery in fragile settings
Year:
2023
Region / City:
Middlesbrough
Subject:
Urgent and palliative radiotherapy
Document Type:
Referral form
Institution:
James Cook University Hospital
Author:
Unknown
Target Audience:
Medical professionals involved in patient referrals for radiotherapy
Period of Validity:
Ongoing
Approval Date:
Unknown
Date of Changes:
Unknown