The Team
The team of seven Clinical Nurse Specialists (CNS's) with specialist knowledge and skills in palliative care are employed by and based at St Catherines Hospice, Lostock Lane , Lostock Hall, Preston .

Who would need to be visited by the CNS
People with advanced cancer registered with a GP in Preston , Longridge, Chorley and South Ribble , who are living in their own homes, or Nursing and Residential Care Homes, who have progressive cancer and are experiencing complex needs.

Who may refer patients to the CNS service?

• G.P. or District Nurses
• Hospital Doctors and Nurses
• Other Clinical Nurse Specialists.

What do we do?
We visit patients in their own home and assess their needs, plan care and review any treatments we may have suggested

• Advise and work closely with G.P.s, District Nurses, patients and carers on how best to manage symptoms such as pain, sickness, breathlessness etc.
• Provide Specialist psychological and emotional support to patients and their carers or relatives
• We liaise closely with the other health care professionals involved in a patient's care

When are patients discharged from our service?
Patients are discharged from our service when:

• The more complex issues and needs have been resolved
• The patient's needs cannot be met by our service and require referral to another service for example, a more advanced level of counselling
• The patient moves out of the area

When a patient has been discharged from our service, should our services be required again, a health care professional can re-refer.

How can the CNS team be contacted?
Monday to Friday (except Bank Holidays) between 09:00 and 10:00 the nurses are available to speak to other professionals, patients and carers. Outside these hours the nurses will be generally out visiting patients and messages may be left with the medical secretary.Messages are collected by the CNS up to 16:00 . Messages outside 09:00 and 17:00 may be left with the Hospice Nurses and will be passed to the CNS at the beginning of the next working day.

Additional information
The team work closely with the Consultant in Community Palliative Medicine and discuss all new patients referred to the service with her in a weekly multi-disciplinary team meeting. The Consultant in Palliative Medicine also has Out-patient Clinics, where patients well enough to attend may be reviewed.

The team also meet weekly with the wider Specialist Palliative Care Team including other Hospice Community and In-patient services, the Hospital Specialist Palliative Care Team of Doctors, Nurses and Social Worker, and other palliative care services including the District Nurse 'Out of Hours Palliative Care Service' and Vine House.

All patients are asked by the CNS at the time of assessment, for their permission to share necessary information with any of the above services that may be considered relevant to the patient's care.

Bereavement care is offered to relatives and carers of patients that have been receiving care from the CNS Service. Those people with more complex bereavement issues may be referred to a bereavement counsellor with the agreement of the bereaved person.