Community Nurse Specialist (CNS) Team

Generic Referral Form

CNS Service description

CNSs provide assessment, support and advice to patients and families in their usual place of residence. They work collaboratively with primary and secondary care, as well as the Hospice MDT, to provide integrated care and refer to other Hospice services as necessary.

CNS Team: Referral Criteria

Patients meet the whole service criteria and have one or more of the following:

  • Symptoms are not well managed by 1st line treatment.
  • Patient and/or family distress negatively impacts on ability to cope/health.
  • Support is required to enable patients and families with complex family dynamics, or communication, learning or cognitive difficulties to access palliative care and care in the last days of life.
  • Issues around treatment/ethical decisions.
  • Dying is complicated by complex care needs, psychological, social or spiritual distress in the patient and/or family.

Standard: Visit within 14 days of triage.

CNS Team: Urgent referral criteria

  • 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 level of distress that is sustained or not transitory or reactive.
  • Specialist palliative care advice around preferred place of care or admission.

Standard: Contact within 48 hours of triage, Monday to Friday. The CNS team does not provide an emergency response, although this might be possible at times after discussion with CNS.