St Clare HospiceReferralsRefer a patient to St Clare Hospice

Refer a patient to St Clare Hospice

If you think a patient under your care would benefit from the support of St Clare Hospice, please get in touch via our First Contact Service.

Professional referrals to St Clare Hospice

We welcome patient referrals to our services from GPs and other health, social or voluntary care professionals, and our First Contact Service is here to make the process as quick and efficient as possible.

By referring someone to St Clare Hospice, you will be ensuring that they have access to specialist, compassionate palliative and end-of-life care that is tailored to their needs.

Make a referral

A St Clare Hospice Registered Nurse is pictured answering the phone. She smiles to the camera.

Referring a patient to St Clare Hospice for hospice and end-of-life care

For referral inquiries or urgent cases, contact our First Contact Service on 01279 773774 (open 8am to 4pm).
Outside of these hours, call our 24 Hour Advice Line on 01279 773773.

St Clare Hospice works in partnership with the West Essex Care Coordination Centre (CCC) to ensure seamless care. We will liaise with all health and social care partners and providers to support each referral. For additional support, the CCC can be reached on 0300 123 5433 (available 8am to 9pm, seven days a week).

Our First Contact Service is here for individuals, relatives, carers and medical and healthcare professionals who want to make a referral to St Clare Hospice.

It provides a seamless and user-friendly pathway to our St Clare palliative care services and is a first point of contact for anyone living in West Essex or the East Hertfordshire borders who would like to find out more about the support available.

As a healthcare professional, you can call our First Contact Service prior to a referral being made. Staffed by our St Clare clinicians supported by a specialist administrative team, your call will be assessed and triaged so that we can identify the right St Clare team to support your patient, or signpost you to other relevant external services that might be able to help.

For more information about our First Contact Service, click here.

We are commissioned by the ICB (Integrated Care Board) to provide care for patients and families on the East Hertfordshire border. In Bishop’s Stortford, Sawbridgeworth and the surrounding East Herts villages, we work alongside Isabel Hospice (based in Welwyn Garden City) to provide Inpatient care.

Patients who live in these areas can choose to receive care at St Clare Hospice’s Inpatient Unit in Hastingwood – especially if it’s easier for their loved ones to visit them here.

Isabel Hospice continues to provide community palliative care across East Hertfordshire, including Hospice at Home, offering support to patients in the comfort of their own homes.

People who are living with a life-limiting illness, or who are approaching the end of life, their relatives or carers can also self-refer directly to St Clare Hospice by contacting our First Contact Service.

Please note: When the patient is already an inpatient elsewhere, we will liaise with the hospital palliative care team.

St Clare Hospice offers free care and support to people living with a life-limiting illness, nearing the end of life, or coping with the loss of a loved one.

We serve the communities of West Essex and the East Hertfordshire border – this is our hospice catchment area. If you’re aged 18 or over and live in this area, you can access our palliative and end-of-life care services at no cost.

Refer your patient to St Clare Hospice

Patient Details

Name(Required)

First Last

NHS number – If known

Date of birth(Required)

Address(Required)

Street Address Address Line 2 Town County Postcode Country

Telephone number(Required)

Is the patient fluent in English?(Required)

Yes

First language, if not English

Does the patient require an interpreter?(Required)

Yes

1. Sex and gender

What is the patient's sex?

Is the patient's gender identity the same as their sex registered at birth?

Please tell us if the patient would like to describe their gender in another way.

2. Disability and long-term conditions

The Equality Act 2010 describes disability as a physical or mental impairment that has a sustainable and long-term negative effect on a person’s ability to carry out normal day-to-day activities.

Does the patient consider themselves to be disabled or to have a long-term physical or mental health condition?

If yes, please tick all that apply.

Physical impairment

Sensory impairment (e.g. sight or hearing)

Learning disability

Learning difficulty

Mental health condition

Neurodivergent (e.g. autism or ADHD)

Long-term health condition

Another disability or condition

If 'Another disability or condition', please detail here.(Required)

Are there any reasonable adjustments or additional support needs we should be aware of to ensure the patient can access our services?

If yes, please provide more details.(Required)

3. Patient's ethnic group

Patient's ethnicity

If the patient's ethnicity is not listed, please detail here.(Required)

4. Patient's religion/belief

Patient's religion/belief

If the patient's religion is not listed, please detail here.(Required)

5. Patient's sexual orientation

Patient's sexual orientation

If the patient's sexual orientation is not listed, please detail here.(Required)

Primary Diagnosis

Please provide details.(Required)

Is the patient aware of their diagnosis?(Required)

Yes

Has the patient consented to St Clare Hospice referral for the reason stated on the referral form?(Required)

Yes

Has a Mental Capacity Assessment been completed?(Required)

Yes

Not applicable

Have Best Interest Discussions taken place?(Required)

Yes

Not applicable

Please provide details.(Required)

Please provide any relevant medical history.(Required)

Referrer Details

Name(Required)

Prefix First Last

Job title(Required)

Email(Required)

Telephone number(Required)

Date of referral(Required)

GP Details

GP surgery name(Required)

Where is the patient at present?

The patient is currently:(Required)

At home

In hospital

Other

Hospital name(Required)

Hospital telephone number(Required)

Hospital ward name(Required)

Ward telephone number(Required)

Discharge date

If in hospital, please provide the proposed discharge date and destination.

If other, please provide more information(Required)

Professionals/services involved in care

Please detail any other professionals/services involved in the patient's care

Family/carer information

Next of kin/preferred contact details(Required)

First name Last name

Address

Street Address Address Line 2 Town County Postcode Country

Telephone number(Required)

Relationship to patient(Required)

Armed Forces Community Status

As signatories of the Armed Forces Covenant, we aim to provide appropriate support to members of the Armed Forces community. Please let us know if any of the following apply to the patient:

The patient is currently serving in the UK armed forces (regular or reserve)

The patient is a veteran (previously served in the UK armed forces)

The patient is a family member of someone currently serving as a veteran

None of the above

Prefer not to say