Once a referral has been received, we endeavour to see the patient on the same day; discussion with us prior to faxing is required as it assists us with prioritising.
We generally review the patient daily (excluding weekends and public holidays) but the patient remains under the care of the referring Specialist whose team is still required to see the patient daily. If you wish to see your patient at the same time as the Palliative Care Team, please let us know and we can call you when we arrive on the ward.
We will contact you directly if we are concerned about your patient or have made major changes to their treatment. Otherwise we will document all our advice and interventions so that you can keep up to date with the patient’s status and action any recommendations as appropriate.
Please contact us, or document clearly, any discharge plans so we can work together. If the patient is discharged at short notice it is essential that we be contacted PRIOR to the patient leaving the ward as we are often responsible for ensuring that community services are put in place. We also write a discharge letter from our Service and need to ensure that our instructions and follow-up plans are consistent with yours. It is also helpful if you can fax us a copy of your hand-written medical discharge letter to facilitate this.
We do not take over the care of patients referred to our Service but occasionally, after discussion with the referring Specialist, we may transfer the patient to Ward 27. Sometimes it may be appropriate to transfer a patient to the Hospice – this must be discussed with us prior to any discussions with patient or family/whanau.
If patients known to us from a previous admission are re-admitted, please let us know as soon as possible so that we can become re-involved. Patients who are known to the “Nurse Maude Community Palliative Care Service” may benefit from referral to the Hospital Palliative Care Service to facilitate continuity – let us know as soon as possible.
In cases of advanced cancer post-op or if there is clearly an ongoing need for analgesics, the Acute Pain Service may recommend that we be involved – please confirm this promptly.
If you believe that a patient has uncontrolled pain or symptoms or if there is a high level of emotional distress or anxiety a referral may be highly appropriate. We are happy to discuss such a case with you if you are concerned.
Information about this Canterbury DHB document (4160):