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P-57 Responding to families in crisis
  1. Sarah Popplestone-Helm
  1. St Richard’s Hospice, Worcester, UK


Introduction Increasing numbers of referrals with increasingly complex problems required us to consider how we could respond more effectively. Navigating emotionally exhausted clients required us to examine ways to streamline the process and provide an effective solution. Learning from the Clinical Nurse Specialist triage service demonstrated that a single point of access was effective.


  • Respond effectively to increasing demand.

  • Involve referral agencies in service innovation.

  • Streamline referrals to ensure clients receive support and advice from the most appropriate person.

  • Filter referrals so that if we do not provide the service then clients are navigated to those that do.

  • Encourage referrers to provide sufficient information which allows the triage team to navigate the client to the most appropriate specialist service as quickly as possible.

  • Reduce the bureaucratic burden.

  • Collect accurate data to measure team workload and potentially realign resources.


  • Contact referrers with details about the proposals.

  • Ensure that referrers are aware of the weekly triage meeting so that they forward referrals in a timely manner.

  • Urgent referrals are logged on a daily basis and immediately triaged by a member of the family support team.

  • Return referrals if insufficient information is provided as this impedes the client receiving the most appropriate specialist support.

  • Measure the impact in terms of referral to initial consultation, length of waiting list and feedback from clients and referrers.


  • Referrers find the single point of access beneficial for clients and themselves.

  • Evaluation of the revised system has generated suggestions for continuous improvement.

  • The electronic record system provides more accurate data for reporting and ensures referrals are managed more effectively.

  • The team reports fewer inappropriate referrals into the family support service.

Conclusions We have learnt from the success of service innovation and improvements made by other specialist teams.

Accurate and sufficient information from referrers is key to ensuring clients receive the most appropriate support.

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