How to refer a patient
LOROS accepts referrals for patients aged 18 and over who live in Leicester, Leicestershire and Rutland, who have a progressive terminal condition and are in need of specialist palliative care.
Referrals are accepted from GPs, hospital consultants and their teams (usually in liaison with the hospital palliative care teams) and the community nurse specialists (Macmillan and long-term condition teams).
For those hospital inpatients whose symptoms are well controlled, or whose discharge plans are in place, a LOROS admission may not be appropriate, even if it is patient preference.
Referrals may be made by SystmOne or by paper using the single referral form. For urgent ward referrals please ring (0116) 231 3771.
The community nurse specialists (CNS) in palliative care are a team of nurses who work closely with GPs to provide specialist advice and support to patients and families.
Each GP practice has a CNS in palliative care who works closely with the practice. The LOROS CNS team covers the majority of city practices and the Macmillan CNS team covers the majority in the county but there is some overlap. See the full list of which clinical nurse specialist covers which GP practice.
When referring to the Community Nurse Specialist team, the referral form for the community nurse specialists in palliative care can also be used.
Please clearly identify the specific reasons for referral.
It is very useful to share relevant clinical information as you refer the patient – for example recent hospital letters, a share with consent on SystmOne, oncology annotations.
All referrals must have the consent of the patient
Inpatient referrals for symptom control
We accept referrals for patients with complex symptoms that are not improving despite treatment. Symptoms may be a combination of physical, such as pain or nausea, and/or psychological/spiritual. Most patients stay less than two weeks before discharge, by which time symptoms are usually under control.
Inpatient referrals for last days of life care
We accept referrals for care in the last days of life though we may not be able to meet the expectation or demand for all patients who choose to come to LOROS.
In addition, the LOROS Day Therapy service accepts referrals from health and social care professionals for unresolved, difficult to control symptoms, psychological and social issues.
The current environment in day therapy may not be suitable for some patients with dementia who wander or are agitated, but all patients will have their individual needs considered.
Community Nurse Specialist team
Referrals will be considered for patients who have:
- A diagnosis of advanced, life limiting illness
- Complex physical, psychological or spiritual symptoms which are escalating and/or unresolved
- Complex social needs resulting from their illness
Please state urgency of response within 48 hrs, one week or two weeks on the referral form. If 48-hour response is required, referral must be accompanied by a telephone call from the referrer – (0116) 231 8402.
Counselling & bereavement service
Referrals can be made for individuals or couples who meet the following criteria:
- The client’s GP is based in Leicester, Leicestershire or Rutland
- The client(s) should be aged 18 or over
- The client is affected by the impact of cancer/end stage illness
The referral criteria for this nurse-led service is any patient with primary or cancer related lymphoedema. The service will also accept referrals for patients with complex secondary lymphoedema. See our clinical guidelines for details of our local antimicrobial guidelines. Professionals wishing to discuss referrals and any concerns can contact a lymphoedema specialist nurse on (0116) 2318429 between 9am and 5pm.
Home visiting service
The home visiting service can provide patients and carers with a home visitor for a few hours a week, to allow carers to leave home with peace of mind and spend time doing other things.
LOROS in Rutland
We now offer a number of services at Uppingham Surgery in Rutland. The services provide support for terminally ill people, their family and carers by providing care and services closer to home and improving their experience and outcomes.
The services available at Uppingham Surgery in Rutland, are:
LOROS Consultant Clinic
Last Wednesday of every month
The clinic is for patients with difficult symptoms.
Lypmhoedema Specialist Clinic
Launching Wednesday 18th January, then the third Wednesday of every month.
We would like to see patients who meet our referral criteria and will offer treatments and discuss options for future care.
Bereavement Support Group
From Wednesday 8th February and on consecutive Wednesdays until 5th April.
We would like to see patients who meet our referral criteria and will offer structured group support as we do at LOROS.
For more information on any of these services please call (0116) 231 8429.
Referral to our Rutland service remains the same as above, through the Hospice.