Trinity is committed to providing accessible, high quality Specialist Palliative Care for everyone affected by an advanced, progressive life limiting illness. Once a patient is referred to Trinity they are able to access the Clinical Nurse Specialist team, In-patient Unit, Day Therapy Unit, Linden Centre, Lymphoedema Service and Complementary Therapy.

As referrers, you can then ensure that your patient can access all or some of the services that they are entitled to.

Referral Criteria

Patient has a progressive, life limiting diagnosis
Has complex problems that cannot be adequately
addressed by current healthcare team
Has a reasonable understanding of their illness, where has
Accepts referral to specialist palliative care services

Patient referral form

We hope this newly designed referral form will help you refer patients easily and effectively.


Click here to complete the Specialist Palliative Care Referral Form (Microsoft Word) electronically. Please save in one of the correct formats requested, and then e-mail the completed form to

Attach any relevant documentation with the referral i.e. list of current medication, relevant out-patient clinic or hospital discharge letters, oncology annotations, etc.

If you have any queries regarding the referral process, please call the CNS Secretaries on 01253 359379.

If you would like to discuss a referral, please contact us on 01253 359379, and a member of the Community or Hospital
CNS Team would be happy to talk to you.

Contact details for key Palliative Care healthcare professionals

Trinity Palliative Care Clinical Nurse Specialist

Trinity Hospital CNS Team: 01253 952566

Trinity Hospital CNS Team: 01253 952566

Specialist Palliative Medicine Medical Advice: Dr Gillian Au - Medical Director, Trinity Hospice 01253 952599

Dr Andrea Whitfield Hospital Consultant via secretary 01253 655672 Or via hospital switchboard
01253 300000

Community Consultant via secretary 01253 359203 Or via Trinity switchboard 01253 358881

Specialist Palliative Care Pharmacist Advice

Andrew Dickman via hospital switchboard 01253 300000

Out of Hours Advice for Healthcare Professionals

Trinity Hospice Advice Line 01253 359359


Brian House referral form

Please click here to download a pdf of the Brian House Referral Form
Completed referrals should be emailed to Janet Miller at


Linden Centre referral forms

If you feel you would like some psychological support around your current situation, please get in touch with us at the Linden Centre.

Bereavement Support: to self-refer or to refer a child

Complete this form

Family member/carer of a Trinity patient

If you are supporting a loved one or struggling to cope with your loved one’s diagnosis and wish to access some psychological support. This can be a self, parental or professional referral.

Complete this form

Medical professional referral for a patient

Referrals can be made by any medical professional.

Complete this form


Please email completed forms to Alternatively, you can phone the Linden Centre on 01253 952582 and complete the referral by telephone.


  • After we have received your referral by email, we will contact you within a week confirming receipt. Please note incomplete forms will be returned for further information.
  • Accepted referrals will be contacted by telephone to book an assessment and after discussion, you may be offered group or individual support according to need.
  • Group work is face to face following Trinity Covid guidelines.
  • The majority of adult counselling is currently completed on the telephone.
  • Children’s group and individual work is completed face to face. The majority of 1:1 children’s work is completed during the school day and there are very limited out of school appointments. Children’s group work is after school .


Lymphoedema referral form

Consultants, GPs or other health care professionals who wish to refer a cancer patient to our Lymphoedema Clinic should complete this cancer-related referral form



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