№ lp_2_2_06979
File format: docx
Character count: 11365
File size: 2741 KB
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.
Price: 8 / 10 USD
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Organisation:
Jersey Hospice Care
Department:
Children and Young People’s Team (CYPT)
Address:
Mont Cochon, St Helier, Jersey JE2 3JB
Contact email:
[email protected]
Telephone:
01534 780 780
Website:
www.jerseyhospicecare.com
Region:
Jersey
Country:
Bailiwick of Jersey
Service type:
Nurse led daytime respite care and palliative support
Service hours:
Monday to Friday 9am–5pm
Eligible age range:
0–18 years
Eligibility criteria:
Life-limiting and life-threatening conditions categorised into four groups according to Together for Short Lives
Referral types:
Young person, parent/carer/guardian, healthcare professional
Sections included:
Consent, Reason for referral, Personal details, Medical history, Professionals involved, Communication preferences
Legal framework:
Data Protection (Jersey) Law 2018
Intended recipients:
Children and young people with life-limiting or life-threatening conditions and their families
Processing note:
For Hospice use only section including triage timeframe and CYPT nurse signature
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:
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
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
Year:
2023
Region / City:
Penn Yan, NY
Topic:
Mental Health Services, Housing Assistance
Document Type:
Referral Form
Organization:
Yates County Adult SPOA
Author:
Yates County Mental Health Services
Target Audience:
Health and social service providers, individuals with mental health concerns
Effective Period:
Ongoing
Approval Date:
Not specified
Date of Changes:
Not specified
Contextual Description:
A referral form for supportive housing, ACT services, and non-Medicaid care management for individuals with mental health diagnoses in Yates County.
Year:
2023
Region / City:
North Central London
Topic:
Healthcare Referral Form
Document Type:
Referral Form
Organization / Institution:
North Central London
Author:
N/A
Target Audience:
Healthcare professionals
Period of Validity:
N/A
Approval Date:
N/A
Amendment Date:
N/A
Year:
2020
Region / City:
United States
Theme:
Emergency Housing Assistance, COVID-19 Response
Document Type:
Referral Form
Author:
SSVF
Target Audience:
Veterans, SSVF Grantees, Community Stakeholders
Action Period:
During COVID-19 Pandemic
Approval Date:
N/A
Date of Changes:
N/A
Context:
A referral form used for Emergency Housing Assistance under the SSVF program during the COVID-19 crisis, outlining eligibility and procedures for providing temporary housing to at-risk Veterans.