Caring is at the heart of everything we do.

Patient Referrals

Adult Hospice Referrals

Who can refer a patient?

The referrer must be a clinical professional who has assessed the patient and main carer(s) and has knowledge of the disease, symptoms, treatments, likely prognosis and the patient’s preferred place of care.

If the referrer is someone other than the person’s GP, they are required to notify the GP that a referral has been made to the specialist palliative care team.

Referral Criteria

The referrer must be satisfied that the person they are referring has an advanced and progressing life limiting illness with:

  • Unresolved complex physical, emotional, social or spiritual symptoms despite previous interventions; AND/OR
  • Patient/carer is in need of specialist end of life support including terminal care and bereavement services; AND/OR
  • A need for specialist palliative rehabilitation with clear functional goals; AND/OR
  • A need for a proposed period of respite provided by specialist palliative care in the case of emergency crisis situations, as per local specialist palliative care provider policy.

Patient Referral

See below for the Referral Form for adult patient referrals only.

Adult Patient Referral Form for Referrers »
Referral Guidance and Services Directory for Referrers »

Re-Referral of a patient to NI Hospice – Community Only

You can re-refer a patient with the rapid access re-referral form to NI Hospice Adult Community Specialist Palliative Care if they have previously been referred to NI Hospice and discharged.

The Adult Community Patient Re-Referral form is available by emailing the referral team at and requesting the re-referral form. You will receive a generic automated response advising your referral request will be dealt with. You will then receive the re-referral form, which you can use as a template for future re-referrals.

See below for the rapid access Re-Referral Form for adult community patient referrals only.

Re-Referral Guidance »

Submit completed forms to: