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Introduction

  • 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 UK 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 service needs

  • The lymphoedema service will endeavour to:
  1. Develop robust systems designed to identify people at risk of, or with lymphoedema regardless of cause to ensure that patients receive high quality education and lifelong support
  2. Provide an equitable and accessible service to patients with lymphoedema/chronic oedema irrespective of age, gender, sexuality or ethnic origin, disability, weight and body mass index (BMI) or aetiology
  3. Develop agreed protocols for the assessment of patients, the treatment of cellulitis and the provision of care including compression garments
  4. Proactively involve patients and their carers in decisions regarding their treatment plan and long-term care of their condition
  5. Provide access to specialist assessment, high standards of evidence-based—or where lacking, consensual—care and treatment packages as appropriate and provide the patient with up-to-date information about their condition
  6. Engage users of the service in developing the service and, as resources allow, develop a support group
  7. 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
  8. Provide specialist advice and education to patients, carers and health professionals regarding the identification of risk factors for lymphoedema and early signs and symptoms
  9. Provide specialist advice about appropriate treatment strategies for those with lymphoedema
  10. Work collaboratively with related disciplines, and healthcare teams to ensure care is co-ordinated, planned and meets the patient’s individual needs
  11. Monitor clinic activity and key performance indicators to demonstrate the efficacy and impact of the service
  12. Services may find it useful to utilise the National Lymphoedema Partnership (NLP) minimum data set
  • 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 predisposition or risk of developing primary or secondary lymphoedema should receive information on:
    1. How to reduce their risk of developing lymphoedema where appropriate
    2. The 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. Who to seek advice from if signs and symptoms of lymphoedema develop
  • The individual with lymphoedema should receive
    1. A referral to a specialist lymphoedema practitioner or service for assessment and diagnosis of their condition once other causes of oedema have been excluded (remembering that most causes of peripheral oedema are due to cardiac, renal, hepatic or venous disease)
    2. An explanation of their condition together with information supported by up-to-date written information
    3. Information regarding self-management strategies for their condition and outlines on how to maintain a healthy lifestyle. Patients should be given encouragement to become competent in these areas
    4. A treatment plan including the provision of compression garments every 6 to 12 months via the lymphoedema service or GP
    5. Information on the management of potential complications such as cellulitis and secondary skin changes, and who to contact in this eventuality
    6. The contact number of a local or national lymphoedema support group
    7. Regular review and monitoring of their condition by a lymphoedema practitioner ideally every 6 to 12 months until self – supported management strategies are fully adopted
    8. Timely discharge from a specialist service, ensuring regular review and monitoring can continue with the patient’s community services
    9. The provision of support and information for carers as appropriate to assist in supporting the individual with lymphoedema needs

Full guideline:

British Lymphology Society, PO Box 7153, Lichfield, WS14 4JW, Tel: 01452 790 178

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

British Lymphology Society. Standards of Practice for Lymphoedema Services. July 2019. 

First included: August 2016.

Last updated: July 2019.