The NHS Constitution for England establishes the principles and values of the NHS in England. The first principle is that the NHS provides a comprehensive service, available to all.

It is available to all, irrespective of gender, race, disability, age, sexual orientation, religion, belief, gender reassignment, or marital or civil partnership status.

As we know, the mental health of ethnic minorities continues to be unmet; have you and your team thought about this and reviewed your caseload?

Please know that we particularly welcome referrals of patients from a wide and diverse background to ensure they are representative of the wider population we serve.

Cassel Hospital,
Specialist Personality Disorder Service,
1 Ham Common,
Richmond,
Surrey,
TW10 7JF

Tel: 020 8483 2900
Fax: 020 8483 2996

Date of referral
Which service do you think would be most appropriate for your patient? (Following screening and discussion we may recommend a different service) Required
Has this referral been discussed and agreed with your NHS England Regional Commissioner?
Address of Local Mental Health Commissioner

Patient details

Date of birth
Address

Referrer details

Address
Required

NHS staff details

(if applicable)

Required

(e.g. housing, probation, social services, voluntary sector) 

(Please provide a summary of the patient’s contact(s) with mental health services, beginning with the first presentation. Please include precipitating factors/risk behaviours and note the patient’s engagement with services if known)

(Please include physical health diagnoses, medications, etc.)

(Please provide a developmental history, including early experiences, significant losses or trauma, quality of family relationships, etc.)

(Please include education, employment, current living arrangements, forensic history, etc.)

(Please describe any safeguarding concerns and any previous safeguarding events)

Would the patient be able to attend a one-to-one assessment? Required
Required