Donate Refer

How to refer

Children’s Hospice South West (CHSW) provides care and support for children and young people, with a broad range of health conditions, who are not expected to live beyond 18 years, including those who do not have a clear diagnosis. Children living with cancer, who may still have a curative outcome, will also be considered.

We welcome referrals from family members or professionals for children at any time during their journey. It is, however, beneficial for families to understand the role of the hospice in caring for children and young people who may not live into adulthood.

The support provided will be tailored to the needs of the individual child and family and is reviewed over time.

Referrals are made to a central CHSW portal, and if the child/young person is accepted to receive support, they will be allocated to either Charlton Farm, Little Bridge House or Little Harbour Children’s Hospice. This allocation will be mainly based on geographical location of the home, although other factors may be taken into consideration including capacity or extenuating circumstances.

Below is the step-by-step process for referrals, please note parental consent form (A) and referral form (B) must be completed in the first instance. The referral forms are designed to give the team enough information in order to establish whether CHSW can offer support, and if the child is accepted, we will look forward to knowing even more about them and their family.

If the referral has been identified as urgent, for example for end-of-life care or a child/young person thought to be in their last weeks of life, please contact your local CHSW hospice via phone.

If you need more information or a paper copy or the referral forms, please telephone 01271 321 999 or email the care team.

Eligibility

All must be met:

  • The child/young person is under the age of 18 at the time of referral.
  • The child/young person lives in South West England. 
  • The child/young person is living with a life-limiting condition or complex health need requiring palliative care input. More information is available directly from CHSW or from the Together for Short Lives website.

For routine referrals please follow the steps below

Step 1
  • Parent/carer to complete consent form (A), AND
  • Parents or professional to complete referral form (B)
Step 2

Step 2 is not applicable to parent/carer referrer – please go to step 3.

If healthcare professional has completed form B, please ask lead paediatrician, via phone or email, to complete medical information form (C) and send an email to the care team.

Step 3

Send forms A and B (and C, if complete) by email to care team.

Step 4

If medical information form (C) has not been received, CHSW will contact lead paediatrician on parents/carers behalf to request completion.

Step 5

Once all forms have been received, the child/young person will be discussed in the CHSW weekly referral meeting. Unfortunately, referrals cannot be considered until Forms A, B and C have been received.

Step 6

Parent/carer will be informed of the outcome of the referrals meeting and, if accepted, to which hospice the child/young person has been allocated. Notifications will also be sent to GP, lead paediatrician and referrer.

Downloads

Download Parental Consent Form A (PDF)

Download Care Referral Form B (PDF)

Download Medical Referral Form C (PDF)

Little Bridge House

Little Bridge House is a beautiful and homely stone built building in North Devon. It is a peaceful and relaxing environment surrounded by lovely gardens that provide plenty of places to play and enjoy the sunshine.

Charlton Farm

Charlton Farm is situated in Wraxall, North Somerset on the outskirts of Bristol. The hospice is an imaginative restoration of a listed farm and farm buildings which has retained the homely feel of the farm house and yet provides stunning and spacious accommodation.

Little Harbour

Little Harbour is a home-from-home. A place where each family member can find time and space to feel normal and do the things they enjoy as a Mum, as a Dad, as a brother or sister: as a family, not overwhelmingly as a carer.