Specialist palliative care services and referral criteria

Once a patient has been diagnosed with a life-limiting illness or their death is expected, you should consider whether referral to specialist palliative care is appropriate. Patients who are having life prolonging treatment can still receive specialist palliative care.

A patient can be referred for:

  • assessment
  • advice
  • consultation
  • support
  • direct patient care
  • assistance with discharge planning.
Referral criteria and triggers
Referral to specialist palliative care leaflet (PDF 829KB)

Referral criteria

The patient has progressive, life limiting or life threatening disease (malignant and/or non malignant) and any of the following:
  • symptoms that require specialist assessment/management and which are beyond the capacity of the primary care team to manage optimally
  • the patient and/or their family has psychological, social or spiritual needs that require specialist assessment
  • the patient is dying and the primary care team requires additional support and/or advice.
Note: Patients who are having life prolonging treatment are not excluded from referral to palliative care.

Triggers for referral

  • the referring clinician would not be surprised if the patient died within the next 12 months
  • recurrent presentations to hospital
  • for inpatients, it would not be a surprise if they died this hospital admission
  • progressive disease despite life prolonging therapy
  • low probability of success from available therapeutic options
  • withdrawal, or consideration of withdrawal, of life prolonging treatment (for example: haemodialysis, ventilation)
  • patient or family concern about end of life issues
  • recent marked decline in physical function
  • care needs exceed carer capacity

Specialist palliative care services

Services are provided in a range of settings, including:

  • outpatient clinics
  • the community
  • residential care facilities
  • hospitals
  • specialist palliative care units

The Guide to specialist palliative care services includes the admission criteria, services provided, and the providers of care (including their referral processes) in each of these settings.

What type of palliative care services will best meet your patient’s needs

Scenario 1

Your patient has a life-limiting illness and has ongoing progressive disease with symptoms that require monitoring and/or needs support at home.

Refer to a community palliative care service.

Scenario 2

Your patient has a life-limiting illness and has pain and/or other symptoms that are not adequately managed and needs specialist assessment (within a couple of weeks) and a management plan that you can then maintain.

Refer to palliative care outpatient clinic.

Scenario 3

Your patient has a life-limiting illness and has severe acute pain and/or other symptoms not responding to the medications prescribed and needs admission to an inpatient facility for a specialist assessment and admission.

Refer to a specialist palliative care unit.

Scenario 4

Your patient has a life-limiting illness and has sever, acute back pain and neurological signs suspicious of spinal cord compression.

Call an ambulance and send to a tertiary hospital emergency department.

Scenario 5

Your patient lives in a residential care facility and the patient/family or care facility needs assistance with information, symptom management and advice regarding ongoing care needs and planning.

Refer to palliative care residential care facility consultancy service.

Produced by

End-of-Life Care Program