nurse and patient in garden

Adult Hospice at Home Referral Criteria

Referrals may be made by healthcare professionals to Rennie Grove's Hospice at Home service for any patient over 18 with cancer or any life-limiting illness which is progressive or chronic with one or more of the following criteria:

  • Those experiencing complex/severe symptoms which have not responded to routine treatments and interventions from the other services and care providers at this current time
  • Due to level of complexity and/or intensity their needs cannot ‘solely’ be met by other services/care providers at this time
  • Dying is complicated by complex symptom needs and psychological/spiritual/social distress in family or patient
  • Patients and their carers having difficulties adjusting/coping with their disease psychologically/spiritually/emotionally and generalist support has not been able to meet their needs
  • Issues around treatment and ethical decisions to support decision making

Patients must meet one of the above criteria and include one of the following:

  • Uncontrolled and/or severe symptoms that are not responsive to first line management
  • Rapid changes in condition where urgent assessment is required to inform clinical management decisions and appropriate place of care
  • High levels of anxiety/distress which is affecting on going care and treatment
  • Primary care involvement/referral must be in place
  • No other Specialist Palliative Care service (SPC) involved
  • Assessment by a registered healthcare professional within the last 48 hours

Referral Priority Categories

Prioritisation of referrals is undertaken based on assessment of need and urgency.  The following categories should be used on referral:

Buckinghamshire Hertfordshire
 Urgent (​first contact within 24 hours)  SP1 (first contact within 2-4 hours)
 Soon (​first contact within 1-4 days)  SP2 (first contact within 24 hours)
 Routine (first contact within >=5 days)  SP3 (first contact within 1-4 days)
   SP4 (first contact within >= 5days)

Process to follow

All referrals must be made through the following:

Bucks -
Single Point of Access (SPA)
Tel: 01296 332608  Fax.: 01963 32645

Herts -
Palliative Care Referral Centre (PCRC)
Tel: 0333 234 0868 Email:

Please note:

  • Rennie Grove will only accept referrals when the patient has given consent to the referral and been made aware of their diagnosis/prognosis.
  • Prior to a first visit the patient will be made aware that following a clinical assessment they will not be taken onto the Rennie Grove caseload if it is felt inappropriate to do so ie they do not meet our criteria
  • Referral for commencing a syringe pump is not a rationale for referral if symptoms are not complex/or if another SPC service is involved
  • An incomplete referral will be returned for further information and no action will be taken by ​Rennie Grove until all fields are satisfactorily completed
  • Care to be given in partnership with existing primary and secondary services
  • Patients to be informed we are a responsive service and not an emergency service
  • If an urgent referral to the service is made, a telephone call from the referrer must be made first to discuss.
  • In-Patients must have a planned discharge date before being referred

Discharge Criteria

All patients will be made aware on the first visit that they will be reviewed on a regular basis and may be discharged from our service if they meet one or more of the following criteria:

  • After a period of care where symptoms have improved or resolved
  • Complex social/psychological or spiritual issues have been addressed
  • On-going patient and family needs can be managed by primary care
  • Patient and family no longer want to receive service or are refusing regular visits for a period longer than ​three months
  • Specialist Nursing care not appropriate to meet patient needs (i.e. social)