For children and young people who have a life-limiting or life-threatening condition requiring palliative care support.
All of the below must apply
The child or young person must
- Be under the age of 18 at the time of referral
- Live in South West England
- Have a life-limiting or life-threatening condition requiring palliative care support
- Not be expected to live beyond 18 years
- More information is available directly from CHSW or from the Together for Short Lives website.
Please follow the steps below
- Parent/carer to complete Parental Consent Form A (download below)
- Parent/carer or professional to complete Care Referral Form B (download below)
- If a professional has completed Form B, please ask Lead Paediatrician, via phone or email, to complete Medical Referral Form C (download below) and to submit it by email to the Care Team. Please note Form C should be completed by a doctor.
- If a parent/carer has completed form A and B and the medical Referral Form C has not been received, CHSW will contact lead paediatrician on parents/carers behalf to request completion.
- Send forms A and B (and C, if complete) by email to the Care Team.
- Once all forms have been received, the child/young person will be discussed in the CHSW weekly referral meeting. Referrals cannot be considered until Forms A, B and C have been received.
- 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 for the coming year. Notifications will also be sent to GP, lead paediatrician and the referrer.