Nightingale Macmillan Unit
Main hospital, level 1, Royal Derby Hospital
(near entrance 24)
The Nightingale Macmillan Unit (NMU) is a specialist palliative care in-patient unit or hospice. It is located on the ground floor (level 1) of the Royal Derby Hospital, just inside entrance 24. NMU moved from its old home on London Road to its new purpose built premises in May 2009.
The patients who are admitted to NMU have a life-limiting illness. This includes people with incurable cancer and also non-cancer illnesses that are advanced and progressing e.g. motor neurone disease or advanced heart failure.
NMU is part of the wider specialist palliative care service.
Reasons for admission
Admission to NMU is arranged for patients who have problems that require more specialist skills than are available in their current care setting.
- management of unresponsive symptoms e.g. pain, nausea, constipation
- management of complex emotional, psychological and social problems
- assessment of changing healthcare needs
- care in the last days of an illness for patients who want to die in the hospice
- Respite care (see below)
A patient's care needs will be assessed and managed. When stabilised, the team will discuss and plan discharge with the patient and their carers. This may be back to a patient's home or to another appropriate care setting. The average length of stay in NMU is 14 days.
Holistic care is an essential part of specialist palliative care. It is provided in NMU by a multidisciplinary team of specialists including:
- consultants in palliative medicine and a team of junior doctors
- nursing team including registered nurses and care assistants
- Macmillan social care worker
- occupational therapist
- complementary therapist
- creative worker
- clinical psychologist
- reception and administration staff
The team will liaise with other healthcare professionals who are involved in a patient's care before, during and after an in-patient stay as needed.
The NMU has:
- bed space for 20 patients; there are 14 single rooms with en suite toilet/shower and two bays of 3 beds (same sex)
- a day room with television, books and games
- a landscaped courtyard garden (shared with NM Day Unit)
- a multi-faith chapel
- personal TVs, internet access
- facilities for in-patients who are smokers (relatives are expected to follow the Trust non-smoking policy)
- a relative’s room and facilities for relatives to stay overnight
Referrals process (for healthcare professionals)
Referrals are accepted from a patient's
- GP, if the patient is at home
- hospital consultant, if the patient is already in hospital
If the specialist palliative care service is already involved in a patient's management e.g. hospital palliative care team or community palliative care team, that team may facilitate the referral.
In working hours referrals should be made directly to NMU: 01332 786060, ask to speak to the doctor taking calls for admissions.
Out of hours
- Contact the hospital switchboard 01332 340131 and ask for the consultant in palliative medicine on-call.
Patients are admitted according to priority when beds are available.
The referrer will be asked questions to establish
- whether NMU is the most appropriate place
- how urgently the admission is required
Emergency admissions/required same day
- if a bed is available, admission will be arranged immediately
- if a bed is not available, then the referrer will be directed to an appropriate alternative
Urgent admissions/required soon but not same day
- the patient’s name will be added to the waiting list
- advice will be given to manage symptoms whilst waiting
- an admissions meeting occurs on a daily basis to review those patients waiting and arrange admission in order of priority
One bed is dedicated to providing respite care. This is available for patients with advanced, progressive neurological conditions and complex care needs that cannot be managed by a care home. Patients are admitted for one week at a time at regular intervals, e.g. every eight weeks. This allows the patient and their carer(s) at home time to recharge their batteries and take part in different activities.
Referral for regular respite care
Referrals should be made via telephone or letter to:
Dr. Swanwick's secretary,
Tel: 01332 788794
Fax: 01332 783077
Palliative medicine secretaries
Rehab & cancer directorate
Level 3 M&G, duite B
Royal Derby Hospital