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Advice & Referral Team (ART)

Who can refer a patient?

Referrals must be made by a healthcare professional. This includes:

The patient's GP,
Hospital doctor,
Clinical nurse specialist,
District nurse.

If you are a healthcare professional, you can find more information below on making a referral.

If you are a patient, please visit our Patient advice page for more information.

Ways to refer a patient

Phyllis Tuckwell has launched a new single point of access for all clinical advice and referrals, in order to streamline the process, and make it clearer and easier for both patients and healthcare professionals (HCPs). This service is run by our Advice and Referral Team (ART) of clinicians and administrators. HCPs can contact them directly to ask for advice about a patient with an advanced or terminal illness, or refer them to the Phyllis Tuckwell service.

Download an outline of the making a referral process.

Speak to our Advice and Referral Team (ART)

Available 7 days a week, from 8am - 6pm.

Out of hours, calls will be transferred to our In-Patient Unit, who will assist.

Phone: 01252 729440

Email: PTH.adviceandreferral@nhs.net

ART can assist with advice and referrals to any of our services.

Complete our referral form (online or download)

Referrals can also be made by completing our referral form. It needs to be completed by the patient's GP, hospital doctor, clinical nurse specialist or district nurse, and should include all relevant clinical and diagnostic information (this helps the clinicians with their review of all referrals and is vital for the effective assessment of patients and their families). There are two ways to complete our referral form:

Complete online (see form below).
Download it here, complete and email to PTH.adviceandreferral@nhs.net (Please note, the referral form consists of two pages which will need to be fully completed.)

Make a referral

Online referral form

The online referral form is split into six steps. Fields marked with * are required.

Step 1 of 6

Type of referral

Is the referral urgent due to rapidly changing needs? If ‘Yes’ phone the appropriate team for advice / assessment.*

Yes No

Did the patient consent to this referral / has a best interest decision been made?*

Yes No

Has the referring clinician informed the patient that their GP notes will be shared with PTHC (PTHC patients only)*

Yes No Not relevant

If patient lacks capacity to consent, has their relevant other been informed?*

Yes No

Please send copies of any relevant recent correspondence to assist responsive assessment e.g. consultant clinic letters, discharge summary and GP patient summary plus CPR status if known.

Continue

Back to step 1

Step 2 of 6

Details of person being referred

First name*

This field is required

Last name*

This field is required

Date of birth*

Required

NHS number*

This field is required

Known as

Gender*

This field is required

Marital status*

This field is required

Email address

Telephone number*

This field is required

Mobile number

Address line 1*

This field is required

Address line 2

Town / City*

This field is required

Post code*

This field is required

Does the person live alone?*

Yes No

Key safe number

Patient’s ethnic origin*

This field is required

If other, please specify

Patient’s religion*

This field is required

Patient’s first language*

This field is required

Back to step 1 Continue

Back to step 2

Step 3 of 6

Next of kin / Patient representative

First name*

This field is required

Last name*

This field is required

Telephone number*

This field is required

Email address

Relationship to patient*

This field is required

Is this person’s address different to the patient? If yes, please enter the address.

Yes No

Address line 1*

This field is required

Address line 2

Town / City*

This field is required

Post code*

This field is required

Does this next of kin have lasting power of attorney?*

Yes No

Main carer

Does the patient have a main carer that’s different to the next of kin? If yes, please enter details*

Yes No

First name*

This field is required

Last name*

This field is required

Telephone number*

This field is required

Email address

This field is required

Relationship to patient*

This field is required

Is the main carer’s address different to the patient? If yes, please enter the address.

Yes No

Address line 1*

This field is required

Address line 2

Town / City*

This field is required

Post code*

This field is required

Back to step 2 Continue

Back to step 5

Step 6 of 6

Referrer information

Full name*

This field is required

Work base*

This field is required

Job title*

This field is required

Telephone number*

This field is required

Secure nhs.net email*

This field is required

Data protection act*
Please ensure the patient is aware information will be held on computer according to the Data Protection Act and will be shared with external healthcare professionals on a need to know basis.

I understand

Back to step 5

Advice & Referral Team (ART)

Who can refer a patient?

Ways to refer a patient

Speak to our Advice and Referral Team (ART)

Complete our referral form (online or download)

Make a referral

Online referral form

Step 1 of 6

Type of referral

Step 2 of 6

Details of person being referred

Step 3 of 6

Next of kin / Patient representative

Main carer

Step 4 of 6

General practitioner

Community Nursing Services

Community professional involved with patient’s care

Hospital

Step 5 of 6

Clinical referral information

Clinical referral information

Step 6 of 6

Referrer information

Advice & Referral Team (ART)

Who can refer a patient?

Ways to refer a patient

Speak to our Advice and Referral Team (ART)

Complete our referral form (online or download)

Make a referral

Online referral form

Step 1 of 6

Type of referral

Step 2 of 6

Details of person being referred

Step 3 of 6

Next of kin / Patient representative

Main carer

Step 4 of 6

General practitioner

Community Nursing Services

Community professional involved with patient’s care

Hospital

Step 5 of 6

Clinical referral information

Clinical referral information

Step 6 of 6

Referrer information

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