The Lymphoedema service provides specialist care for patients living with primary, secondary lymphoedema and chronic oedema.
The service will operate clinics Monday to Friday, 08.30-16.30 and will aim to support patients who meet the specified referral criteria. We will provide the following to clinicians and patients who access the service:
– Management advice
– Partnership working alongside practitioners to provide assessment and management guidance and care
– Specialist care to patients who meet the criteria
– Specialist advice to patients and health care professionals in managing swelling and preventing erosive skin breakdown for those on our caseload
The current average waiting time for the Lymphoedema service is 7.1 weeks.
Accessing the service
We accept referrals from health care professionals on behalf of a patient. If you are not receiving care from a health care professional, then you can simply contact us to find out more.
If you do approach us direct, we may need to ask you for additional information about your condition and speak to your doctor (GP) to understand a little more. If you already have a health care professional you may find it helpful to ask them to contact us for you.
Indications for Referral:
Patients with Chronic oedema/Lymphoedema with Lymphorrhoea (weepy/wet legs)
Patients with a history of repeated celllulitis related to oedema
Secondary Lymphoedema/Chronic oedema; swelling that has been present for longer than 3 months not reducing on elevation
Lymphoedema secondary to cancer
Contra-indications to referral include:
Patients with known ischaemia of the affected limb: an ABPI ≤0.5. If concerned refer to vascular surgeon
Patients with unstable cardiac/renal failure as compression therapy may be contraindicated. Once stabilised referral may be made to the Lymphoedema Service
Obesity where the patient has refused a weight reducing programme or is not prepared to adopt weight reducing measures.
Patient does not have a Bromley GP.
Please note that the short and long term success of treatment is dependent upon the patient’s ability to understand and comply with a programme of care that is tailored to suit their individual needs.
Patients who self-manage their lymphoedema and obtain repeat compression garment prescriptions from their GP.
Patients whose needs are being met by their primary and/or social care providers.
When there is no further scope for making an impact on a patient’s need.
When a patient chooses not to attend Lymphoedema Clinic appointments or consistently fails to work within an agreed treatment plan.
Guidance for Referrers:
Please include the full medical history where possible to enable a full assessment to be completed.
All housebound patients will need to be known to Adult Community nursing services and wherever possible will be visited with the district nurse responsible for that patient’s care.
Once patients are stable in a maintenance regime they will be discharged back to the primary carer for long term maintenance. This will usually involve repeat emollients and a 6 month hosiery review. The patient can self-refer in the initial 6-12 month period following discharge if there are any difficulties. If the patient requires service access 12 months or longer following discharge, a full referral is required to include an update of the patient’s medical history to enable a contemporary and comprehensive assessment based upon the recent history.
Changing or cancelling an appointment
Please give us as much notice as possible if you need to cancel your appointment.
Please cancel your appointment with your health care professional who will contact the Lymphoedema service on your behalf.
There are a number of organisations that provide information and support with regards to lymphoedema.
Lymphoedema Support Network (LSN) We are a registered charity run by people who live with lymphoedema. We are the UK’s largest information provider about the condition, supporting patients, carers and health care professionals alike.
The British Lymphology Society (BLS) The main aims of BLS are to promote awareness about lymphoedema to the public, health care professionals.
Some patients may have lipoedema in conjunction with lymphoedema. Lipoedema UK offers information and support.
Lead Tissue Viability Clinical Nurse Specialist: Gillian Harman