Referral Form

Please note that this form should only be used by healthcare professionals making a referral for patients to Mountbatten Hampshire’s services.

Contact Details
Referral for Community Palliative Care Services, Mountbatten Hampshire
Mountbatten Care Coordination Centre - 02382 548860
Email: [email protected]

Please ensure patients are aware information will be held on computer according to Data Protection Act

TO ENSURE TIMELY PROCESSING OF REFERRAL, PLEASE ENSURE ALL INFORMATION IS COMPLETE AND PATIENT HAS CONSENTED TO REFERRAL

About the patient

The Mountbatten Coordination Centre is a service for people who may be identified as being in the last five years or so of life, or who have palliative care needs. It is for people living with any disease in which a deterioration may be life-threatening. The service is for those living in the city of Southampton and large parts of Hampshire.

The Mountbatten Coordination Centre operates alongside and supports existing core services, such as GPs, community nurses, specialist nurses and social care practitioners. It also acts as a single point of access for our specialist care service. A minority of patients and families who have highly complex physical, psychological, social and spiritual needs will access this service.

The Mountbatten Coordination Centre supports choice by:

Improving the coordination and continuity of care and support for patients and their families/carers.

Introducing a central 24/7 contact telephone number - 02382 548860.

Offering information and support and enabling direct access to support for health and social care professionals, patients and their families/carers.