Referral to emergency

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.

  • nil

In the event of sudden and/or acute deterioration (excluding end of life care), please consider referring the patient to the emergency department (ED), via ambulance if necessary. Health professionals should use their clinical judgement when considering such referrals, with consideration given to patients' clinical status/goals of care/resuscitation status. The decision to refer to ED should be made in consultation with the parent/caregiver and statewide Paediatric Palliative Care Service.

Patients/families known to the statewide Paediatric Palliative Care Service, and health professionals caring for these patients can contact the service directly with any concerns, and for advice with assessment and management. This service is available 24 hours, 7 days a week.

For clinical advice, please telephone the relevant specialty service.

Women's and Children's Health Network

  • Paediatric Palliative Care Service (08) 8161 7994, 8:30 am to 4:30 pm, Monday to Friday, exclusing public holidays
    • after hours contact Women’s and Children’s Hospital switchboard (08) 8161 7000 and ask to speak to the Palliative Care Service

The Paediatric Palliative Care Service provides a statewide consultative service. Health Care Professionals can call for advice and guidance including but not limited to;

  • the appropriateness of referral to palliative care
  • symptom assessment and management
  • psychosocial support
  • bereavement support & resources. 

Inclusions

Palliative care where in

  • patient has a life-limiting illness
  • patient or decision makers is aware of, understands and has agreed to palliative care referral
  • referral is made in collaboration with patient/family and treating teams

Exclusions

  • nil

Triage categories

Category 1 (appointment clinically indicated within 30 days)

  • end of life care, less than 2 weeks
  • rapid escalation of symptoms
  • unstable symptoms
  • high risk rapid deterioration
  • recent discharge from hospital
  • multi-aspect family needs/fragile family
  • high level home resource management
  • multiple agency communication
  • inter-current illness
  • early in disease trajectory
  • bereavement support

All patients/their families will be contacted within two weeks of referral receipt.

Category 2 (appointment clinically indicated within 90 days)

  • nil

Category 3 (appointment clinically indicated within 365 days)

  • nil

Essential referral information

Completion required before first appointment to ensure patients are ready for care. Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

  • medical information
    • life limiting diagnosis, including date of diagnosis
    • reason for referral
    • past medical history, comorbidities and allergies
  • social information
    • details of consent to palliative care service
    • guardianship orders
    • family demographic

Additional information to assist triage categorisation

  • current end-of-life care and resuscitation plan
  • relevant specialist involved in care
  • current medications
  • medical correspondence
  • relevant radiology and pathology results

Clinical management advice

South Australian Paediatric Palliative Care Service

The South Australian Paediatric Palliative Care Service is a statewide service with reach into Northern Territory and part of rural Victoria and New South Wales. The service provides specialist holistic child and family centred care to antenatal, neonates, children and young people with life limiting conditions and supporting those who care for them.

  • Our vision is to help children and families live life to the max
  • Our mission is to provide excellent service to neonates/children and families facing life limiting illness.

Care is provided across the illness journey from diagnosis to death and into bereavement through:

  • partnership with families and clinicians to provide individualised, holistic, patient and family centred care
  • specialised interdisciplinary team combining medical, nursing and psychosocial expertise
  • provision of care across location including in home, hospitals, inpatient, outpatient as well as schools and community agencies
  • coordination, collaboration and advocacy with health care and community services;
  • fostering families and carers capacity, strength and resilience to care for children with life limiting illness (LLI) in the location of their choice
  • respecting the unique cultural, spiritual and religious beliefs and practices of families and communities around children with LLI
  • recognition that care of the dying is urgent
  • recognition of the unique grief responses and needs of parents, siblings and family and community.
  • access to 24/7 on call support provided by the Medical Consultants for patients/families and health care professionals to ensure continuous access to palliative care expertise.

The Paediatric Palliative Care team works collaboratively with primary clinical teams in caring for children with LLI. Care is provided across locations including hospital (across Local Health Networks), the community and home. The service provides integrated interdisciplinary care for families of antenatal/neonates/children with life limiting illnesses from antenatal diagnosis through to 19 years of age, across South Australia and into Northern Territory and rural Victoria/New South Wales. Specialised and responsive interdisciplinary care tailored to the holistic needs of the patient and family and provided

in the location of their choice. Care includes medical, nursing and psychosocial care with goal focussed approaches to work with families and health and care providers to identify and work towards goals for child and families experiencing LLI. Care includes:

  • specialist palliative medical assessment and management including complex medical care, identifying goals of care, pain and symptom management.
  • communication, coordination, support and continuity of care by Nurse Consultants. Development of care plans and communication pathways.
  • specialised psychosocial care to assess and support needs of the child and family. Emphasis on whole family care and finding the child’s voice with art therapy.
  • bereavement care and coordination for 2 years following the death of a child. This may be provided as group therapy, individual therapy, peer mentor programs, regular contact points.
  • access to consumer led strengthening connections peer mentor program linking previously bereaved parents who have received specialised training with current families within the service to provide individualised peer / lived experience support.

Key partnerships include working with community services, Royal District Nursing Services (RDNS), schools and disability framework (NDIS).

Clinical resources

Consumer resources

Reason for request

  • to establish a diagnosis
  • for treatment or intervention
  • for advice and management
  • for specialist to take over management
  • for a specified test/investigation the General Practitioner cannot order
  • for other reason (e.g. rapidly accelerating disease progression)
  • transfer of care from another tertiary service
  • clinical judgement indicates a referral for specialist review is necessary.

Patient demographic details

  • full name, including aliases
  • date of birth
  • residential and postal address
  • telephone contact number/s – home, mobile and alternative
  • Medicare number, where eligible
  • name of the parent or caregiver, if appropriate
  • preferred language and interpreter requirements
  • identifies as Aboriginal and/or Torres Strait Islander

Clinical modifiers

  • impact on employment
  • impact on education
  • impact on home
  • impact on activities of daily living
  • impact on ability to care for others
  • impact on personal frailty or safety
  • identifies as Aboriginal and/or Torres Strait Islander

Other relevant information

  • Willingness to have surgery, where surgery is a likely intervention.
  • Choice to be treated as a public or private patient.
  • Compensable status, e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.
  • Relevant social history, including identifying if you feel your patient is from a vulnerable population, under guardianship/out-of-home care arrangements and/or requires a third party to receive correspondence on their behalf.
  • Triage of a specialist outpatient referral is based on clinical decision making to allocate an appropriate urgency categorisation.
  • Where appropriate and where available, the referral may be streamed to an associated public allied health and/or nursing service. Access to some specific services may include initial assessment and management by associated public allied health and/or nursing, which may either facilitate or negate the need to see the public medical specialist.
  • A change in patient circumstance (such as condition deteriorating or pregnancy) may affect the urgency categorisation and should be communicated as soon as possible.
  • All new referrals will be triaged by a consultant and appointment times scheduled according to clinical urgency.

Adolescents transitioning from paediatric to adult specialist services require a formal handover from paediatric specialist clinician to adult specialist clinician as well as a formal referral from the referring specialist to ensure initial transfer of care is completed.

The General Practitioners role in this process is to provide support to patients as part of holistic care. All ongoing referrals to specialists can subsequently be provided by the General Practitioner once the transfer of care has occurred.