Referrals

Dorothy House provides care, free of charge, within our catchment area of
North and West Wiltshire (Wilts), Bath and North East Somerset (B&NES)
and the North–Eastern part of Somerset (Mendip).

1) The criteria. Who is eligible for our care?

1.1 Anyone over the age of 18 with active, progressive and advanced disease which is also life limiting. This includes, amongst others, diseases such as cancer, heart and/or lung disease, and neurological diseases. As long as the patient fits this criterion, co-morbidities will never preclude a decision to provide care.

1.2 Patients being referred may be close to the end of their active treatment phase i.e. when a clinician has advised the patient either that no further treatment will be of benefit or that further treatment is purely for the relief of difficult and often distressing symptoms.

1.3 Family and/or carers looking after the patient at home or in other settings may be referred in their own right if their situation is complex and they need additional help and support in order to continue their caring role. (Please note this still requires a patient referral even if we are not required to care for the patient).

1.4 A patient in the end of life phase of their illness trajectory who has chosen to die in a hospice.

1.5 The patient (or their chosen representative i.e. their advocate or the person carrying out a health and welfare Enduring/Lasting Power of Attorney) must agree with the referral.

Please note: If the referring clinician has not sought the opinion of the GP in relation to the referral then DH will always discuss the referral with the GP concerned before agreeing to see the patient.

Please also note that if your patient does not meet these criteria we can still offer support and advice (mainly by telephone via our Advice Line) to you and your colleagues.

We also offer

a) training/education on issues that may be relevant to you as a clinician / professional.

b) visits to the hospice to spend days with DH clinicians.

c) attendance at your GSF/QoF palliative care meetings to assist with discussions about any of your patients that we are not caring for.

2) Who may make a referral to DHHC?

Referrals may come from you as the clinician/professional but we do accept referrals from patients, family or carer(s). Any professional (i.e. a GP, a district nurse, a social worker, staff at the hospital where the patient is receiving treatment) may make a referral. However it is important to note:

• we will always seek permission from the relevant GP to become involved.
• we will always inform other health or social care professionals involved in the patient’s care.

3)  How to make a referral to DHHC

3.1 Referrals must be made on a fully completed referral form, so that we have the correct information for the benefit and care of the patient. The form may be faxed to our confidential fax line 01225- 722907 or sent by post. It may not be sent by email. Referral forms are also available at all GP practices and main hospitals in our catchment area or can be requested from us on the referrals number: 01225-721477.

3.2 Please, as a referring professional attach recent letters, scan and blood test results and any other relevant information, so that we may safely proceed with caring for the person(s) being referred.

Download the Dorothy House Referral Form [129kb PDF]

4) What happens after referral?

The referral form lists all of our services here at DH. If at all possible, the referring professional should specify the required services.

Our multi-disciplinary team look at the referral and ensure that it fits our criteria. If it does we will

a)    Allocate care, initially, to one department with a named clinician responsible (most probably a nurse specialist in the first instance).

b)    The team will commence their care by telephoning the patient (unless the referral specifies we should ring the person making the referral or a member of the family) to make an appointment to see them at home or in our out-patient wing at Dorothy House or at another setting such as an outreach centre belonging to DH.

c)    If the first referral we receive is for our in-patient unit then the IPU will discuss the needs of the patient with the professional making the referral. When admission has been agreed (see criteria for admission to IPU) we will contact the patient to make the arrangements. Please note that for any admission the referring person/organisation is responsible for safely getting the patient to Winsley.

d)    Each department has its own referral guidelines. We have these guidelines so that we can be as fair as possible to all those who live in our catchment area.

If the referral we receive does not fit our criteria or we have reservations, we will contact you (and possibly the patient) to explain why we do not think the referral is appropriate for DHHC. 

Our End of Life Care Pathways may help you decide whether to refer a patient. They have been ratified and are used by both B&NES and Wiltshire PCT’s. With use, they have evolved into three sections reflecting the needs of patients at different times.

Download our Care Pathways here [303kb PDF]

Please note a new triage system is being piloted and we reserve the right to change your referral requests but we will let you know the outcome.

5) Timing  

DHHC prides itself on responding to referrals in a very short time. Our standards are:

Urgent referrals are CONTACTED within 1-2 working days.

Soon referrals: are CONTACTED within one week.

Routine referrals are CONTACTED within 2 weeks.

(Please note that this initial CONTACT does not mean a visit. It will more than probably be a telephone call in which a visit is arranged for a mutually convenient place, time and date.)

Our response is often much faster than these timescales, but it depends on the individual’s needs and on the other demands for our care at the time. We believe that all care should be timely and we realise that waiting for us to respond after a referral will cause anxiety. We try to keep the waiting time as short as possible.

Conversely, a referral may take more time to reach us than anticipated and therefore our response may appear to be slower than indicated above. If this is a cause of anxiety, a simple phone call to us should resolve the problem.

Finally, we reserve the right to alter the process of referral but if we do so we will always a) publish these changes on the website, b) write to our referring professionals