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 Little Bridge House, Charlton Farm 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 Parent consent (Form A) and Referral (Form B) (downloads below) 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 must:

  • be under the age of 18 at the time of referral
  • live in South West England.
  • living with a life-limiting condition or complex health need requiring palliative care who are not expected to live beyond 18 years. 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 Parent consent (Form A) (download below), AND
  • Parents or professional to complete Referral (Form B) (download below)
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 referral (Form C) (download below) 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 referral (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.

Download Parent consent (Form A) (PDF)

Download Referral (Form B) (PDF)

Download Medical referral (Form C) (PDF)

For urgent new referrals please follow the steps below

Step 1

Referrer telephones the relevant hospice, this would ordinarily be the hospice closest to the child's home address, Little Bridge House in Devon 01271 321 999, Charlton Farm in North Somerset 01275 866 611, Little Harbour in Cornwall 01726 655 55

Step 2

Hospice administration team discuss the urgent referral with the Duty Manager and Doctor of the day.

Step 3

Duty Manager and Doctor of the day discuss and return phone call to the referrer as soon as possible. In that phone call:

• the referrer is asked to email through completed Parent consent (Form A) (download above)

• the CHSW Team will complete the CHSW Urgent new referral (Form D) verbally with the referrer. This form is below to show the information required.

Step 4

The decision is made regarding the eligibility and feasibility of hospice support. The referrer is informed of the outcome as soon as possible. If transfer planned then arrangements are made in the usual ways, which may include convening an MDT +/- in reach to the current place of care.

Download Urgent new referral (Form D) (PDF)

Little Bridge House

Little Bridge House is a located in the village of Fremington, North Devon.

Charlton Farm

Charlton Farm is situated in Wraxall, North Somerset on the outskirts of Bristol.

Little Harbour

Little Harbour is set in a spectacular coastal location overlooking St. Austell Bay.