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Strategy for lymphoedema care


  • The British Lymphology Society is a registered charity whose objects are to advance education and knowledge in the field of lymphology and related subjects; to foster interest in and co-ordinate a strategy for improving the management of chronic oedema, particularly lymphoedema; to produce and maintain a register of specialist centres in the United Kingdom and Ireland and to benefit patients by improving the knowledge, expertise and skills of health care professionals treating them
  • These standards are produced to provide a benchmark for all healthcare professionals and commissioners when providing care for people with lymphoedema
  • Lymphoedema arises when the lymphatic system inadequately fulfils its function of regulating fluid balance in tissue spaces. This results in oedema or swelling, which may occur anywhere in the body, but most commonly affects the limbs. It also causes changes in the skin and body tissues, which do not occur in other chronic oedemas. Lymphoedema may be classified as Primary or Secondary

The lymphoedema service will endeavour to

  • Provide an equitable and accessible service to patients with lymphoedema/chronic oedema irrespective of age, gender, sexuality or ethnic origin
  • Proactively involve patients and their carers in decisions regarding their treatment plan and long term care of their condition
  • Provide access to specialist assessment, high standards of evidence-based, or where lacking, consensual, care and treatment packages as appropriate To provide the patient with up to date information about their condition
  • Engage users of the service in developing the service and, as resources allow, develop a support group Reduce the complications of lymphoedema and chronic oedema which can cause distress to the patient and worsening of their condition, such as cellulitis, secondary skin changes, disability and lymphorrhoea (“leaking legs”) and in turn reduce hospital admissions with cellulitis
  • Provide specialist advice and education to patients, carers and health professionals regarding the prevention of lymphoedema where there is a known risk
  • Provide specialist advice about the treatment for those with lymphoedema
  • Work collaboratively with related disciplines, and health care teams to ensure care is co-ordinated, planned and meets the patient’s individual needs
  • Monitor clinic activity and key performance indicators to demonstrate the efficacy and impact of the service
  • This is achieved through the provision of specialist clinical advice and evidence-based practice, research and implementation of local and international clinical practice guidelines and policies for lymphoedema and chronic oedema

Patient needs

  • The patient with a pre disposition or risk of developing primary or secondary lymphoedema should receive information on
    1. How to reduce their risk of developing lymphoedema where appropriate
    2. What signs and symptoms may indicate the onset of lymphoedema
    3. Details of a local or national lymphoedema support group for further information and ongoing support
    4. If signs and symptoms of lymphoedema develop, the individual should be referred to a lymphoedema specialist once other causes of oedema have been excluded (remembering that most causes of peripheral oedema are due to cardiac, renal, hepatic or venous disease)
  • The individual with lymphoedema should receive
    1. A referral to a specialist lymphoedema practitioner or service for assessment and diagnosis of their condition
    2. An explanation of their condition together with information regarding self management strategies for their condition
    3. A treatment plan including the provision of compression garments every 6 to 12 months via the lymphoedema service or GP
    4. Information on the management of potential complications such as cellulitis and secondary skin changes, and who to contact in this eventuality. Availability of written and verbal up to date information.
    5. The contact number of a local or national lymphoedema support group
    6. Regular review and monitoring of their condition by a lymphoedema practitioner ideally every 6 to 12 months
    7. When a patient is discharged from a specialist service, there is provision to ensure regular review and monitoring can continue
    8. Carers should receive support and information as appropriate to assist in supporting

Commissioning of lymphoedema services

  • GP Consortia and NHS Commissioning Board should
    1. Provide adequate services for all people with lymphoedema which are open during working hours—ideally Monday to Friday 9–5pm
    2. Work with existing lymphoedema services, cancer networks and users to identify the need for further lymphoedema services in their locality
    3. Where there are inadequate lymphoedema services, or there is need beyond the scope of the lymphoedema service in the locality, make provision for referral to other services as appropriate
    4. Develop a standardised approach based on the BLS/LSN Consensus Guidelines for patients with lymphoedema/chronic oedema presenting in acute or primary care for cellulitis treatment (www.thebls.com)
    5. Provide the means for lymphoedema practitioners to maintain their professional practice
    6. Develop services in line with the long term condition nature of the condition such as the provision of psychological, physiotherapy and occupational services

full guidelines available from…

British Lymphology Society, The Garth House, Rushey Lock, Tadpole Bridge, Buckland Marsh, Nr Faringdon, Oxfordshire, SN7 8RF. (Tel – 01452 790178) 

Email: info@thebls.com Website: www.thebls.com

British Lymphology Society. Strategy for lymphoedema care. March 2013. 

First included: June 2014.