Specialist Palliative Care Assessment
Adult

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Emergency Referrals

Useful Management Information

We are a Monday – Friday 07:30 – 04:00pm service. The SPCS is a consultative service that provides holistic specialist assessments from the multidisciplinary team including medical, nursing, occupational therapy, physiotherapy, social work, psychology and pharmacy. We work together with the generalist palliative care and primary care providers such as general practitioners, community nurses, allied health providers, and other treating specialists and may supplement their care where required. Support may be provided to patients from within their homes including residential aged care homes, outpatient departments or via telehealth.

The Community Service team provide a consultative service in patients’ homes and provide support to the GP and other teams when necessary. Care may be in conjunction with the NGO Nurses.

Triggers to consider a referral include:

The referring clinician would expect the patient to pass away within the next 12 months
Recurrent presentations to hospital
For inpatients, it may be possible they could pass away during hospital admission
Progressive disease despite life prolonging therapy
Low probability of success from available therapeutic options
Withdrawal, or consideration of withdrawal, of life prolonging treatment (for example: haemodialysis, ventilation)
Patient or family concern about end-of-life issues
Recent marked decline in physical function
Care needs exceed carer capacity.

Minimum Referral Criteria

Does your patient meet the minimum referral criteria?

Category 1 (appointment within 30 calendar days)	The patient has a progressive, life limiting disease (malignant and/or non-malignant) and any of the following: Anticipation of complex palliative care needs in the foreseeable future. Pain or symptoms which the primary care team require further advice to manage optimally. The patient and/or their family has complex psychological, social, spiritual, or cultural needs that require palliative care support. The patient is dying, and the primary care team requires additional support and/or advice
Category 2 (appointment within 90 calendar days)	Patient, family, or referring clinician requests palliative care support, with no identified urgent palliative needs.
Category 3 (appointment within 365 calendar days)	No category 3 criteria
If your patient does not meet the minimum referral criteria Assessment and management information may be found on a range of conditions at HealthPathways If the patient does not meet the criteria for referral but the referring practitioner believes the patient requires specialist review, a clinical override may be requested: Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.) Please note that your referral may not be accepted or may be redirected to another service

Standard Referral Information

Reason for request

To establish a diagnosis
For treatment or intervention
For advice and management
For specialist to take over management
Reassurance for GP/second opinion
For a specified test/investigation the GP can't order, or the patient can't afford or access
Reassurance for the patient/family
For other reason (e.g. rapidly accelerating disease progression)
Clinical judgement indicates a referral for specialist review is necessary

Relevant clinical information about the condition

Presenting symptoms (evolution and duration)
Physical findings
Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
All conservative options that have been pursued unsuccessfully prior to referral
Body mass index (BMI)
Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
Any special care requirements where relevant (e.g tracheostomy in place, oxygen required)
Current medications and dosages
Drug allergies
Alcohol, tobacco and other drugs use

Patient's Demographic Details

Full name (including aliases)
Date and country of birth
Residential and postal address including whether patient resides at an aged care facility
Telephone contact number/s – home, mobile and alternative
Medicare number (where eligible)
Name of the parent or caregiver (if appropriate)
Name of delegate and contact details (Department of Corrective Services)
Preferred language and interpreter requirements
Identifies as Aboriginal and/or Torres Strait Islander
Any special needs, access requirements and/or disability relevant to the referral

Referring Practitioner Details

Full name
Full address
Contact details – telephone, fax, email
Provider number
Date of referral
Signature
Nominated general practitioner’s details (if known), if the nominated general practitioner is different from the referring practitioner

Other relevant information

Willingness to have surgery (where surgery is a likely intervention)
Choice to be treated as a public or private patient
Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

Essential Referral Information

Reason for referral
Patient’s and family’s consent to referral – and reason why if patient / family have not given consent
Current goals of care
Current ceiling of care
Confirmed diagnosis and treatment to date
Detailed history of present signs and symptoms
Past medical history/pertinent social history
Anticipated prognosis
Current medications and allergies
Available radiology reports (past 12 months) relevant to primary diagnosis
The following pathology from the past 3 – 6 months
- FBC results
- U&E results
- LFT results
- LDH results
Patient’s physical ability to attend an outpatient appointment at the hospital or home visit required

Additional Referral Information

PCOC score
RUG/AKPS scores if known
Record of relevant discussions that have occurred with the patient and family if possible
Histology report/s
Home services patient is currently engaged with (Home Care Package/My Aged Care approvals/community services E.g BlueCare) and how often
Advance care planning documentation
History of any voluntary assisted dying (VAD) requests

Send Referrals To

Smart Referrals

Preferred Method Smart Referrals

Secure Web Transfer

Medical Objects Account: GQ42150009Z

HealthLink EDI: Qldgchsd

Internal Referrals

Specialist Palliative Care qhRefer

Fax

(07) 5687 4497

Post

Gold Coast University Hospital
1 Hospital Boulevard
Southport QLD 4215

Enquiries

1300 744 284

Related HealthPathways

No directly related pathways found

HealthPathways home page

Service Availability

Dr Andrew Broadbent

Medical Director Palliative Care

Facilities

Gold Coast University Hospital

Robina Hospital

If you would like to send a named referral, please address it to the specialist listed above, who will allocate a suitably qualified specialist to see the patient. Alternatively, you can view a full list of our specialists.

Specialist Palliative Care AssessmentAdult