Our Services

Definitions of Lymphoedema

Primary lymphoedema is caused by congenital abnormalities of the lymph-conducting system.

Secondary or acquired lymphoedema is caused by damage to the lymphatic vessels and/or lymph nodes or by a functional deficiency. It may also be the result of a high-output failure of the lymphatic circulation when the function of the overloaded system eventually deteriorates.

Aims of the Service

The aim of the service is to deliver specialist education, support, information, and treatment of primary and secondary-related lymphoedema using a holistic approach.

To improve the overall quality of life for patients living with lymphoedema or lipoedema by devising individualised care plans and promoting self-management and well-being.

The intention is to reduce hospital admissions by engaging patients, carers, and health care professionals in the importance of skin care to prevent cellulitis and its effects both acutely and chronically on lymphoedema.

Information for professionals

Referral process

A referral form is required to be completed by a health care professional and emailed to whcnhs.lymphoedemaworcestershire@nhs.net. The referral form can be found by clicking the link below.

Lymphoedema Referral Form

Please note our referral criteria below.

We aim to see all routine referrals within ten weeks of referral. Urgent referrals are offered to patients with a palliative diagnosis, we aim to make contact within five working days of the referral being accepted

We are happy to provide advice outside of a referral, please contact us on the email address above.

Referral criteria

The patient must meet ALL the following criteria in order for the referral to be accepted:

• The patient must be over 18 years old.
• The patient must be registered with a Worcestershire GP.
• The patient must have consented to the referral and be willing to engage in and continue with the agreed treatment plans and self-management.
• The patient has a definite diagnosis of primary or secondary lymphoedema or lipoedema that has not responded to first-line treatment, which is deemed to be at least a RAL standard classification of compression of 18–21 mmHg and has been in place for a minimum of the last 6 months. If you would like further advice on this, please contact the service via email, not via the referral form.
• Patients should be mobile enough to be able to attend the clinic to be assessed. Except for patients with a life-limiting diagnosis who are truly housebound, this will be assessed on an individual basis.
• For patients with leg ulcers or leaking lymphorrhoea, the service will provide only remote advice.
• The patient must have a BMI < 30; see the note below for patients with a greater BMI.

Patients with a BMI above 30 need to be offered dietary advice and support, which has resulted in consistent weight loss over a 3–6 month period prior to referral to the service. Rationale: Obesity is the major cause of lymphoedema, and weight loss will improve symptoms and general health and well-being, which are all essential in supporting patients to achieve good outcomes from treatment and self-management.

British Lymphology Society —  Guidelines on the Management of Cellulitis in Lymphoedema

This is a comprehensive guideline for health care professionals to determine the treatment of cellulitis in patients with lymphoedema. The aim of this policy is to potentially reduce hospital admissions for cellulitis by engaging patients, carers, and health care professionals in the recommended oral antibiotic treatments and to prevent cellulitis from creating further lymphatic failure in an already compromised lymphatic system.

Useful Websites:

• British Lymphology Society - Lower Limb Inflammatory Pathway
• Lymphoedema Support Network
• Lipoedema UK