Introduction Hospices are familiar with late referrals which happen for a variety of reasons. Following a series of delayed and late referrals where patients had then taken the initiative to contact the Hospice themselves the clinical team undertook a self-referral pilot after which self-referral became a formal access route into hospice services.
Aims By reviewing all self referrals we aimed to understand the reasons why self referrals are made, and the outcomes.
Methods Clinical secretaries complete a self-referral form on receipt of phone call or letter. The referral is triaged in the normal way, additional clinical information sought from GP or hospital clinicians and the patient assessed by doctor or CNS according to need. We collected data on self-referrals from the period of one year (April 2013 to March 2014) during which we received a total of 740 referrals.
Results There were 19 self referrals (2.6% of total referrals) of which 15 were appropriate for specialist palliative care. Cancer was the diagnosis in 74%. The majority (14) had symptom control needs. Only two had immediate end of life care needs. Most patients (14) were at home on referral, but two self referrals were received for hospital in-patients.
Conclusion Self-referral is a good mechanism for patients to access services: the hospice has adopted it as a formal referral method. There was no evidence to suggest that large numbers of people were referring themselves inappropriately. Reference to the possibility of a self-referral is made on the hospice’s public website although it has not been specifically promoted to healthcare professionals. Numbers of self referrals are monitored monthly and are increasing with 39 self-referrals received in 2014–15.
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