Macmillian Palliative Care Support Service

 
Guidelines for Referrers
 
The service focuses on the needs of palliative care patients in the final stages of their illness, and 
offers support enabling the patient to remain in their own home. 
 
Eligibility Criteria
  • Patients who are over 18 and registered with a GP within Selby & York locality 
  • Patients must meet the “fast track” continuing care criteria - care may also be available from Marie Curie and York Against Cancer, these patients do not have to meet the “fast track” criteria but MUST have a cancer diagnosis 
  • Patients must have District nurse involvement and nursing care plan, risk and handling assessment completed and in place in the patient’s home. 
Delivery of Service
 
The service is provided by carefully selected Health Care Assistants (HCA’s) who have special training and continuing education and development. Whilst in the patient’s home, they will report to, and be supported by, the district nursing team responsible for the patient or the district nursing team on call, who is accessible by mobile phone for advice. 
 
The service HCA’s can provide basic care, sensitive and empathic support, day and/or night care.  The minimum length of shift is four hours, maximum 9hrs duration. The times are negotiated on an individual basis according to patient/carer need. 
 
The service HCA’s are NOT able to advise on or recommend any treatment. HCA’s are NOT permitted to administer any tablets, injections or medication of any kind. The informal care/family member will be asked to take responsibility for this. The District Nurse on duty remains accountable for the delivery of care. 
 
The service does not guarantee full 24 hour support. 
 
How to make Referrals 
  • Referrals will be taken from the District Nurses, Macmillan Nurses (or key workers), the service does NOT take referrals directly from patients or their carers 
  • The referrer will be required to ensure that the patient is eligible for fast track, documentation is completed and to confirm this with the service co-ordinator 
  • Referrals are made by telephone to the service co-ordinator (01904 724474) between 8.30am – 4.30pm Monday to Friday 
  • Outside normal working hours information regarding HCA availability can be accessed through the district nursing team on call 
  • The referring nursing team will be asked to give a handover/update to the HCA before visiting 
  • The co-ordinator will contact the patient/carer with the name of the allocated HCA and inform of any subsequent changes to allocation 
  • The service aims to respond to requests within the same working day whenever possible 
Review Process
 
In order to maintain equity and most effective use of available resources, the co-ordinator will 
make regular contact with the referrer for an update and review. 
 
Discharge Criteria
 
Patients will be discharged from the service in the following circumstances: 
  • On admission to hospital, hospice or nursing home 
  • In the event of death 
  • Needs met by alternative continuing care service 
  • At request of patient/carer 
Discharge from the service will be managed and agreed by district nursing teams, the co-ordinator and providers of continuing care support, patient and carer. This will not prevent access to the service on future occasions if eligible. 
 
The service endeavours to be reactive and responsive in a changing situation 
 
Information about Marie Curie Nursing 
  • Marie Curie nursing is accessed via your district nurse. They will make a booking via the Macmillan Palliative Care Support Service on 01904 724474 between 8.30am – 4.30pm, Monday to Friday 
  • Outside normal working hours they will contact Marie Curie direct. – see above