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Lymphoedema Service Update

Lymphoedema Service Update. Gillian McCollum / Pippa McCabe Lymphoedema Clinical Leads. Belfast Trust. Who are we? Predominantly outpatient service 3.2 WTE clinical staff Admin support/therapy assistant just appointed (vacant since Feb 2009)

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Lymphoedema Service Update

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  1. Lymphoedema Service Update Gillian McCollum / Pippa McCabe Lymphoedema Clinical Leads

  2. Belfast Trust Who are we? • Predominantly outpatient service • 3.2 WTE clinical staff • Admin support/therapy assistant just appointed (vacant since Feb 2009) • Clinical Lead coordinates & develops the services in SEB & NWB – 0.5 WTE clinical & 0.5 WTE non clinical

  3. Belfast Trust Lymphoedema Specialists South & East Belfast Service: • Jill Lorimer (0.7 WTE) • Diane Stronge (0.5 WTE) • Louise Kerr (0.5 WTE) North & West Belfast Service: • Emma Christie (0.5 WTE) • Tanya Coppel (0.5 WTE)

  4. Where do we see patients? South & East Belfast: Cancer Centre, BCH Holywood Arches Centre Domicillary North & West Belfast: Ballyowen HC Carlisle HWB Centre Grove HWB Centre Domicillary Belfast Trust

  5. South Eastern Trust Who are we? Service commenced Feb 2008, consisting of: • Pippa McCabe – Clinical Lead (0.8 WTE) • Laura Patterson – Lymphoedema Specialist (1.0 WTE) We also have other lymphoedema trained physiotherapists in the trust who treat specific groups of patients: • Janet Gabbey (oncology in-patients) • Lesley Nelson (palliative care)

  6. South Eastern TrustWhere do we see patients? Out-Patients In-Patients • Ards Community Hospital • Bangor Health Centre (although less regularly) • Marie Curie Centre Belfast • Lagan Valley Hospital • Downpatrick – Pound Lane Health Centre • Ards Community Hospital • Bangor Community Hospital • Ulster Hospital • Lagan Valley Hospital • Downpatrick Hospital • Downshire Hospital

  7. Other services • Specialist palliative care service in the community, NI hospice, Marie Curie & acute oncology service in the cancer centre also treat some lymphoedema patients • Those patients who have chronic skin and/or wound issues may be treated in conjunction with TVN, practice nurses or district nurses • Involve wider multidisciplinary team as necessary – GP, dietician, podiatry, OT etc

  8. Who do we see? • Primary lymphoedema patients • Congenital abnormality of lymphatic system • Can be hereditary • May be associated with a syndrome, for example:

  9. Who do we see? • Secondary Lymphoedema Patients • obstruction or interruption of the lymphatic system by an external cause

  10. Advice and information on skincare and exercise Manual Lymphatic Drainage Multi-Layer Lymphoedema Bandaging What services do we provide?

  11. What services do we provide? Compression Garments Kinesio taping Teach patient & their carers self management techniques 6 monthly review appointments Access to a quarterly complex clinic with involvement from dermatology, vascular and palliative care consultants

  12. Other roles & achievements • Education – trust programme; pre & post graduate training; courses; advice booklets etc • Belfast Trust Lymphoedema Network - partnerships with relevant specialities such as vascular, dermatology, oncology etc • Facilitating implementation of cardiovascular & cancer service framework standards • PR campaign – Belfast Telegraph (Nov 2009) • Research • Clinical Minimum Data Set • Engagement with PPI For further details see www.lnni.org

  13. Waiting list Increase in rate of referral Must meet access targets of 9 weeks Increase in complexity of cases Length of intensive treatment required varies greatly from 2 weeks – 6 months 6 monthly reviews

  14. Variety of Lymphoedema Cases Simple Arm Lymphoedema Complex Leg Lymphoedema

  15. Concerns & Issues Major reforms within health service Funding Efficiency savings Recruitment Lack of dedicated treatment space Limited capacity of lymphoedema service

  16. Solutions to the issues?? Raise profile of lymphoedema & lobby at Stormont – but need to be realistic Raise awareness – patient & professional education Promote early diagnosis & referral → less intensive treatment required for acute stage of condition Empower patients & their carers to self manage this chronic condition

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