Kendal Lymphology Centre
Application for funding for: Non cancer related Lymphoedema Treatment
(Lower Limb)
Indications for referral
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Swelling of the lower limbs/body due to a failure of the lymphatic drainage system (due to
benign/primary lymphoedema or damage from trauma, surgery, infection, or chronic skin
disorders
Swelling of the lower limbs associated with chronic venous insufficiency
Swelling of the lower limbs associated with venous stasis (gravitational/dependant oedema)
Swelling associated with Lipoedema
Contraindications for treatment
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Patients awaiting diagnosis of malignancy or its recurrence
Patients undergoing radiotherapy or chemotherapy
Patients with an arterial insufficiency (with an ABPI of<0.8)
Vena caval obstruction/portal hypertension
Patients who have had a recent deep vein thrombosis (within the last 8 weeks)
Patients with uncontrolled cardiac failure
PATIENT DETAILS (Please complete all the following questions)
Name: __________________________________________________________________________
NHS Number: _________________________________________________________________
Date of Birth: _____________________________________________________________________
Address and post code:
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Consultant:______________________________________________________________________
GP Contact details and Tel. Number:
________________________________________________________________________________
______________________________________________________________
____________________________________________________________________________
Patient Tel No: ___________________________________________________________________
Diagnosis: (please attach any relevant correspondence)
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Completed By (Please Print):
Please return this referral form to:
Mrs Cate Swift (Contracts Manager)
NHS Cumbria, Headquarters,
Lonsdale Unit,
Penrith Hospital,
Date: ______________________
Bridge Lane, Penrith, CA11 8HX
Kendal Lymphology Centre
Notes on Referral for Lymphoedema Treatment
Notes for Referrers
Lymphoedema is a condition which can cause substantial physical and psychological
distress and restrict quality of life considerably. However, it can be alleviated with a
treatment known as Decongestive Lymphatic Therapy (DLT). This includes a daily package
of care over 3 weeks and includes:
 The application of Multi Layer Lymphoedema Bandaging (MLLB) to improve the
overall shape and size of the limb(s)
 Manual Lymphatic Drainage (MLD) – a specialist form of gentle massage which
enhances the drainage of fluid from the swollen limb. This is especially useful when
facial, genital or midline oedema is problematic
 Compression therapy, using custom made high grade therapeutic hosiery, made to
measure
 The use of Kinesio Taping where necessary to further improve congestion and
relieve discomfort
 Specific, exercise to address/improve function, mobility and posture
 Skin care to improve and maintain skin integrity and prevent infection
 Psychological support to enable the patient to come to terms with this life long
condition.
 Regular reviews and follow ups to ensure ongoing support and monitoring
Funding
Until recently, funding for Lymphoedema has been very difficult – a detailed understanding
of the benefits of lymphoedema management is only just coming to light and there is still a
widely held view that lymphoedema is an untreatable condition.
Although treatment may be obtained privately, where intensive DLT is indicated for a
patient, the GP or Consultant may apply to Cumbria PCT for funding of this treatment.
The local PCT have been very supportive of non-cancer related lymphoedema referrals
(there is provision for Cancer and upper limb primary Lymphoedema’s via the Morecambe
Bay Hospitals) and will normally fund an annual package of care through Kendal
Lymphology Centre (following an assessment).
Referrals for lymphoedema funding should be directed to:
Mrs Cate Swift (Contracts Manager)
NHS Cumbria, Headquarters,
Lonsdale Unit,
Penrith Hospital,
Bridge Lane,
Penrith,
CA11 8HX
Once initial assessment funding has been approved, a lymphoedema assessment
appointment will be arranged and subsequent treatment outlined for further PCT funding
approval.
Reports of the patient’s progress will be sent to the referrer on a regular basis.
For further information on Lymphoedema or its treatment, please contact:
Denise Hardy (Clinical Nurse Specialist – Lymphoedema)
Kendal Lymphology Centre, Tel: 01539 735111