Inpatient Care

In-patient Access Policy and Referral Procedure
Dr Chris Sugden, Consultant in Palliative Medicine: Monklands area
Dr Gordon Canning, Consultant in Palliative Medicine: Hairmyres area
Dr Catriona Ross, Consultant in Palliative Medicine: Wishaw area
Mrs Susan Dillet, Hospice Director of Nursing Services

Access Policy for in-patient referral

St. Andrew’s Hospice is open to patients suffering from any life threatening condition and presenting with complex needs.
Blank forms may be faxed from the Hospice to your ward/GP surgery on request.
Referring agencies e.g hospitals and community services are requested to complete a hospice admission form stating clearly the reason for referring e.g.
1. Symptom control.
2. Rehabilitation.
3. End of life care.
The admission form contains a symptom scoring section that must be completed.
The hospice operates a waiting list for admission with a daily review by the multidisciplinary team of the patients listed.
Priority is given to patients with the most complex needs as assessed from the scoring system on the admission form coupled with updating information from the referrer.
Due to the demand for beds coupled with the high occupancy rate, the hospice is unable to plan respite admissions.

Person responsible for access decisions

The hospice consultant on duty will take responsibility for access decisions, having consulted with the relevant professionals.

Responsibility of Referrers

Referring agencies requesting admission for categories 1 and 2 should be in a position to accept patients back into their care upon discharge.
Early communication with social work prior to the patient’s admission is vital to ensure that the care package will resume on discharge.
St. Andrew’s Hospice is a Specialist Palliative Care Unit and is not designed to be a long stay facility. Our aim is to work with patients and families to maximize the potential of the individual, controlling symptoms where possible and facilitating discharge back into the community e.g. home nursing home or alternative care.
It is often detrimental to a patient’s social and psychological well being to remain on a hospice ward for longer than necessary.
Please ensure that the referral has been discussed with the patient and career. A hospice information booklet should be given to the patient prior to admission.

Symptom Control

Listed below are some of the symptoms that may improve with input from the specialist palliative care team.

Intractable pain.
Nausea & vomiting.
Dyspnoea.
Anorexia and Fatigue.
Psychological, spiritual ** and social distress.
Patients in the terminal phase of their illness when complex issues may arise such as communication with distressed families, withdrawal of futile treatment, shifting emphasis from cure to care, respecting the patient’s autonomy and choice.

**Spiritual in this context is not necessarily connected with religious belief.

Referral pathway

Who can refer?

Consultant Medical Staff.
Junior Medical Staff with consultant approval.
Ward Sisters and Staff Nurses with consultant approval.
General Practitioners.
District Nurses and Macmillan nurses with GP approval.

Please ensure that you have discussed hospice referral with patient and family.
Preferred route for routine referrals-

The completion of a hospice referral form.
Blank forms may be faxed from the hospice to your ward/ GP surgery on request.
Post or fax completed forms to St. Andrew’s Hospice (fax No 01236 748786).
The hospice will endeavour to respond to the referrer within 48hrs. This may include telephone advice to referrer and/or the offer of an assessment visit to the patient if appropriate.

Preferred Route for Emergency Referrals -

By telephone call to Dr Sugden/ Dr Canning/ Dr Ross at St. Andrew’s Hospice 01236 766951 with a completed referral form following.
We aim to see your patient or give advice to the staff caring for the patient within 24 hrs.
Post or fax completed forms to St. Andrew’s Hospice (fax No 01236 748786).
Emergency (including out of hours) admission to the hospice will be considered, by the consultant on call, for patients who have recently been discharged from the unit or who are otherwise well known to the hospice service. It is considered inappropriate to admit other categories of patient as out of hours emergencies.

Notes on completing the STAS symptom scores.

Guidance notes on how to complete the STAS forms are to be found on all application forms.
The scores for each symptom should be made in consultation with the patient.
Subjective scoring of symptoms by staff should be avoided unless the patient is unable to comply in which case this should be stated on the form

Hospice Referral Form: Click Here

In addition to this service, hospital staff will be able to obtain advice from a member of the Specialist Palliative Care Team at St. Andrew’s Hospice 24hrs a day by telephoning 01236 766951