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A referral can be made to Jigsaw from anywhere in Cumbria by anyone involved in the care of the child with a life limiting condition ensuring consent has been gained from the child/young person, carer or parent. Direct referrals from the young person themselves, parents or through a third party are also considered. 

Download the relevant referral form and email it to

Referral information:

Jigsaw takes children up to 25 years however the referral process must be completed before the child’s 18th birthday. 

As part of the referrals process: 

  1. You will be allocated a dedicated nurse. 
  1. All professionals involved in the coordination of your care will be contacted to provide further information. 
  1. You will receive a home visit with your designated nurse to have a full nursing assessment completed. 
  1. Your referral will be discussed at our multi-disciplinary meeting and a decision will be made. 
  1. Your nurse will communicate this decision for you and support you through next steps.

Referral criteria:

Referrals are taken for those children who have life limiting conditions and complex health needs within the groups (below). 

The following categories give guidance. 

Life threatening conditions for which curative treatment may be feasible but can fail and where access to palliative care services may be necessary when treatment fails. Children in long term remission or following successful curative treatment are not included.  

Examples: cancer, irreversible organ failures of heart, liver, kidney.  

Conditions where premature death is inevitable, where there may be long periods of intensive treatment aimed at prolonged life and allowing participation in normal activities.  

Example: cystic fibrosis.

Progressive conditions without curative treatment options, where treatment is exclusively palliative and may commonly extend over many years.  

Examples: Batten disease, mucopolysaccaridoses, muscular dystrophy.

Irreversible but non-progressive conditions causing severe disability leading to susceptibility to health complications and the likelihood of premature death.  

Examples: severe cerebral palsy, multiple disabilities, brain or spinal cord injury.

For urgent referrals or if you have any queries, please contact our care team who will be happy to help.

PLEASE NOTE: Please ensure an NHS number is provided on the referral form, as well as copies of recent hospital letters, relevant past medical history and current medication regimes.