Make A Referral Header

Make a Referral

Access our care and services by calling 01474 320007

Make A Referral Header

Make a Referral

Access our care and services by calling 01474 320007

Make A Referral

Self-referral (Adults, Young People and Children)

If you would like to refer yourself or a child to access our care and services then, please call 01474 320007 or complete the below referral form and return to us via email at

Our specialist clinical teams will discuss your referral in detail and advise you on what happens next.

Referral Forms

Referred by a healthcare professional

If you have been referred by a healthcare professional, you must:

  • Have, be caring for, or be part of the family of someone with a life-limiting condition.
  • Agree to the referral.


You could be referred for some of the following reasons:

  • pain/symptom control
  • psycho-social support (for patients and families)
  • spiritual support
  • complex end of life care
  • end of life decision-making.

Your Healthcare professional will provide our teams with copies of any relevant hospital letters and medication details. Referrals may be delayed if insufficient information is provided as this is needed to carry out a full assessment.

On assessment of the referral, we offer a specialist triage service which ensures that you are assessed and seen within appropriate timescales. We provide emergency care and admissions to those who are deemed suitable.

Categories of conditions suitable for referral

Group 1

Potentially fatal condition where treatment has changed from curative to palliative or complex symptom control issues during treatment which has curative intent but may fail i.e. cancer, complex co-morbidities.

Group 2

Treatment available to prolong life but uncertain prognosis i.e. organ failure, COPD, heart failure, cystic fibrosis.

Group 3

Palliative treatment from the outset with no cure available. Motor neurone disease, multi-system atrophy, dementia, Parkinson’s, Huntington’s etc.

Group 4

Static neurological conditions but severity causing complex medical needs that are of a life-threatening nature i.e. stroke, brain damage, cerebral palsy.

Access other services

Please call 01474 320 007 if you would like to access any of the below services:

Our specialist teams will discuss your requirements in detail and advise you on next steps.