The lead clinician should ensure patients receive timely and appropriate referral to palliative care services. Referral should be based on need rather than prognosis.

• Patients may be referred to palliative care at initial diagnosis.
• Patients should be referred to palliative care at the first recurrence or progression.
• Carer needs may prompt referral.

Early referral to palliative care can improve the quality of life for people with cancer (Haines 2011; Temel et al. 2010; Zimmermann et al. 2014). This is particularly true for poor-prognosis cancers (Temel et al. 2010). Furthermore, palliative care has been associated with the improved wellbeing of carers (Higginson & Evans 2010; Hudson et al. 2015).

Ensure carers and families receive information, support and guidance regarding their role according to their needs and wishes (Palliative Care Australia 2005).

The patient and carer should be encouraged to develop an advance care plan (AHMAC 2011). For more information refer patients and carers to Palliative Care Australia.