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Referring A Patient
The Ethos of St Joseph’s Hospice
St Joseph’s Hospice delivers specialist palliative care. The goal is to achieve the best quality of life for our patients and their families by providing an active, holistic approach. The management of pain & other symptoms, and the provision of psychological, social & spiritual support are paramount.
We aim to work in collaboration with our patients, their families and carers and to communicate regularly with other healthcare professionals involved in our patients’ care.
St Joseph’s Hospice is set within an ethnically diverse area. We aim to meet the varying needs and expectations of all our patients, their families and carers, whatever their cultural, spiritual or ethnic background.
We are supported by a comprehensive bilingual and advocacy service.
Which Patients are Appropriate for Referral to St Joseph’s Hospice?
St Joseph’s hospice supports patients who have potentially non-curable conditions with specialist palliative care needs. These conditions include advanced cancer or other progressive non-malignant diseases (for example Motor Neurone Disease, end stage COPD or cardiac failure).
We offer inpatient admissions to adult patients (>18yrs). In the community setting we can also support younger patients who are in need of adult palliative care services.
We envisage that most of our patients will be in the last few years of their life but will see patients who are symptomatic at any stage of their illness.
St Joseph’s Hospice specialist palliative care triage nurse is contactable on 0208 525 6047 within office hours.
If there is a lack of clarity about whether a patient is appropriate for St Joseph’s Hospice, please do not hesitate to discuss a potential referral with the referral team.
St Joseph’s Hospice catchment area
Our community team visits patients in the local PCT areas of City and Hackney, Tower Hamlets and Newham. We admit patients from these areas and also those patients whose GPs are located in Camden and Islington, Waltham Forest, Redbridge, Enfield and Haringey.
Services provided by St Joseph’s Hospice
- Admission
- Symptom Control
- Terminal Care
- Respite
- Rehabilitation
- Longer term care for people with exceptional specialist needs
- Community Palliative Care
- Day Hospice / Outpatient services
- Psychological support
- Bereavement support
Detail of services offered:
Symptom control admissions are normally 2 weeks or less duration. The specialist multidisciplinary team intensively assesses, reviews and treats the patients’ needs. This team consists of the following core professionals: medical, nursing, physiotherapy, social work, occupational therapy and spiritual support. Depending on the patients needs, further referrals may be made to complimentary therapies, psychological support, psychiatry, anaesthetics (eg. for consideration of nerve blocks), dietetics, or speech therapy.
Terminal Care admissions are normally 2 weeks or less duration.
It is important that open discussions about the patients’ preferred place of care have been explored prior to admission, as St Joseph’s would want to actively support patients in their wish to die at home if this was their preference.
St Joseph’s aims to be flexible in our approach in meeting our patients’ needs at the end of life by supporting them, and offering pre-bereavement support to their families (including children) & carers.
Patient accommodation is provided by a mixture of single rooms and two and four-bedded rooms. There are facilities for family members to stay overnight. Spiritual support can be offered by our links with Chaplaincy, Imams, Rabbis and other leaders from faith groups.
Respite admissions are normally 2 weeks or less duration.
St Joseph’s Hospice aims to provide a structured approach to respite care. These admissions should be planned and the expected date of discharge agreed with an appropriate care package set up to support the patient’s timely discharge. The goal is to support patients and carers; preventing fatigue and maximizing families’ quality of life, thus enabling ongoing patient-care in their own home. We aim to maintain and maximize a patient’s current level of functioning during these admissions.
Rehabilitation
Rehabilitation can be offered for patients who have specialist palliative care needs with clearly defined aims of rehabilitation. These objectives would be agreed in advance between the referring health care professionals (eg the community or hospital physiotherapist) and St Joseph’s Hospice inpatient team.
These admissions would normally be of 2 weeks or less duration and should aim to link closely with ongoing rehabilitation in the community. There would be a weekly multidisciplinary review of the patient’s goals and a strategy for ongoing management should rehabilitative goals not be met.
Longer stay patients with exceptional specialist palliative care needs
The specialist team at St Josephs Hospice will consider on a case-by-case basis, requests for longer admissions for patients who have exceptional needs. These admissions would normally be of 3 months duration or less. The focus of care would be regularly reviewed and discussed at MDT meetings and may include exploration of more appropriate placement options, according to the patient’s needs. Funding agreements will need to be negotiated prior to transfer.
St Joseph’s Hospice Community Palliative Care Team referrals (CPCT)
Patients whose GPs are in City and Hackney, Tower Hamlets and Newham can be referred to the CPCT. This applies to all local residents including those living in residential or nursing homes.
Each borough has a multi-professional team with allocated palliative care Clinical Nurse Specialists, specialist social workers and hospice doctors who provide medical support.
The service is advisory, aiming to work in partnership with the General Practitioner who retains primary responsibility for patient care. The aims of CPCT input are to ensure symptoms are well controlled, and that patients and families are well supported at home with psycho-social needs met. To achieve this, the CPCT will liaise closely with other community services to maximise patient care and may refer to inpatient hospital/hospice services as required. We aim to keep primary healthcare teams fully informed of our involvement at all times.
Members of The CPCT visit patients and their families at home, making recommendations and providing support that addresses their physical, social, psychological & spiritual needs. Depending on the case, the patient will then be visited and telephoned at regular intervals to provide ongoing support throughout the course of their illness. Our team can be telephoned for advice by patients, their carers and healthcare professionals both in and out of office hours.
If appropriate we will help patients understand their health and treatment options so they can plan their future care, including what they would like to happen should they enter the terminal phase.
Day Hospice / Outpatient Services
Patients within the local boroughs of City and Hackney, Tower Hamlets and Newham can be referred to Day Hospice services.
Patients can come to the hospice for part or all of the day for specialist treatments, for day respite care, social support and creative diversional opportunities (eg pottery and painting, creative writing and story telling). In addition patients can access complimentary therapies, and psychological care (1:1counselling and an art therapy group).
Other specific groups include lymphoedema management and breathlessness management. We will be developing additional drop-in services, including easily accessible information about a range of issues.
In addition St Joseph’s is looking to develop additional support for carers in the future.There is already a monthly support group for carers and people affected by Motor Neurone Disease
Bereavement Support
Adult service - bereavement support is offered to all families and carers of our patients.
We are able to provide a range of services, to meet the varying expressed needs of the bereaved including individual counseling and group support, and can refer people to services locally to their home address if necessary.
Kites – provides bereavement support to children, young people and their carers living in East London, this service is not restricted to patients of the hospice. We have a team of therapists (play therapy, and art therapy) and counselors, and accept referrals from a wide range of agencies including GPs and Schools.
Out of Area Referrals
Each year, we do receive a small number of referrals for care from patients whose GP’s are based outside our catchment area. These patients may choose to come here because their family is based here or for other reasons. In these cases, if the patients are medically suitable and there is bed availability, Hospice staff will make an out of area referral to the appropriate PCT for funding. If this is accepted then the patient can be accepted for care.
St Joseph’s Hospice working as partners with other healthcare professionals
Due to the complex nature of our patients’ needs, St Joseph’s Hospice staff recognise the importance of good, clear & timely communication with other health and social care professionals. We aim to ensure that GPs, other members of the Primary Healthcare, social services and hospital teams are kept fully informed and involved in the care of patients within the community setting.
This should allow the delivery of seamless care to palliative care patients who often have rapidly changing psychosocial needs and physical health.
Patients who require investigations or more intensive treatment than can be offered by St Joseph’s Hospice will be referred to hospital if clinically appropriate.
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