Lymphoedema service

What is lymphoedema?

The lymphatic system is a network of vessels and glands, forming part of your immune system but is also responsible for helping to maintain the balance of fluid within your body, by draining excess fluid from the tissues. When the lymphatic system is not working correctly fluid builds up within the tissues and causes the affected area to swell, this is called lymphoedema. It can affect any part of the body but is most commonly seen in an arm or a leg.

There are two types of lymphoedema: primary or secondary. Primary lymphoedema is due to a defect within the lymphatic system, present since birth but can develop without obvious cause at different stages of life, usually up to early adulthood. Secondary lymphoedema is damage caused to the lymphatic system, for example through; trauma, infection, reduced mobility, cancer and some cancer treatments.

What is lipoedema?

Lipoedema is the abnormal buildup of fat cells in the legs, thighs and buttocks, with occasional arm involvement but excludes the hands and feet. The cause is not known but is considered an inherited condition, as in 50% of cases there is a family history, almost exclusively affecting women. It tends to start at puberty or times of hormonal change and develops gradually. A person with lipoedema may eventually develop lymphoedema if the fat cells prevent drainage of the lymph fluid.

The Lymphoedema has been serving the population of North Devon and North Cornwall since 2006. This is a nurse led service comprising of two full time specialist practitioners with part time admin support. The service is provided Monday to Thursday during the hours of 08:00 hours and 17:00 hours and Friday 08:00-13:30, with appointments held at Barnstaple Health Centre. The team provides advice, support and development opportunities to other professionals: North Devon District Hospital, Community hospitals, Community Nurses, Practice Nurses, North Devon Hospice and Care Homes to enable on-going care of patients. Referrals are welcomed from a variety of Health Care Professionals for primary and secondary cancer and non-cancer related lymphoedema and lipoedema. Referrals can be made via EPIC, BOB electronically or in writing. The service aim is to provide evidence based, high quality, best practice for people with these two long-term conditions, in line with local, national and international guidelines.

A holistic assessment will be undertaken by one of the Specialist Practitioners and a joint management plan regarding treatment will be made on clinical need.

How do I access the service?

Patients are referred to the service by other healthcare professionals including GPs, Practice Nurses, Community Nurses, North Devon District Hospital and North Devon Hospice, using the referral criteria found on the hospital intranet or in writing.

Meet the team

• Georgina Martin, Macmillan Lymphoedema CNS and Service Lead
• Angela Ives, Macmillan Lymphoedema Specialist practitioner
• Laura Morris, Administrator
• Kim Craze, Administrator

The Eastern Cancer Lymphoedema team serves the population of Exeter and East Devon. This is a nurse-led cancer service comprising of two part-time Macmillan Cancer Clinical Nurse Specialists with part-time admin support.

This is a cancer predominately outpatient service, with appointments held at the Heavitree Hospital site in Exeter. The Team provide a limited inpatient service with complex cancer cases or work alongside the cancer MDTs to support the MDT and / or patients where appropriate with preventive measures or general advice

The team also provides advice and support to other professionals within primary care and the community.

This is an acute cancer service and referrals are welcomed from Health Care Professionals for cancer related secondary lymphoedema. However, we also accept referrals for primary (genetic) lymphoedema and lipoedema, who require specialist advice.

For non-cancer related lymphoedema, although the service is cancer focused the team will offer advice and guidance only when they can.

Services and treatments

The aim of this service is to provide evidence-based, high-quality, best practice in line with local, national and international guidelines.

A face-to-face holistic assessment will be undertaken to determine a patient centred decongestive management plan by one of the Macmillan Cancer Clinical Nurse Specialist based on clinical need.

How do I access the service?

Referrals can be made via EPIC or via the GP e-referral system. For patients out of area please request referral to the Lymphoedema Service for your locality.

How do I contact the team?

For enquiries/admin team Tel: 01392 405655 / Email: rduh.lymphoedemanursespecialists@nhs.net

Via EPIC referral.

The aim of this service is to provide evidence-based, high-quality, best practices in line with local, national and international guidelines.

A face-to-face holistic assessment will be undertaken to determine a patient-centred decongestive management plan by one of the Clinical Nurse specialists based on clinical need.

British Lymphology Society
9 – 11 Oldbury Road
Cheltenham
Gloucestershire

GL51 0HH

Tel: 01242 695077
Fax: 01242 695125
Email: info@thebls.com
Web: www.thebls.com

For the consensus document on the management of Cellulitis in Lymphoedema go to:
www.thebls.com
Click on ‘Home’ – Scroll to bottom of the page -Click on ‘BLS Consensus’

Lymphoedema Support Network
St Lukes Crypt
Sydney Street
London
SW3 6NH

Tel Information and Support 020 7351 4480
Tel Admin 020 7351 0990
Fax 020 7349 9809

Email: www.lymphoedema.org

Macmillan Cancer Support
890 Albert Embankment
London
SE1 7UQ

www.macmillan.org.uk

Cancer line: 0808 808 2020

Breast cancer related lymphoedema

Compression garments

Head and neck simple lymphatic drainage (SLD)

Lipoedema

Lower limb simple lymphatic drainage (SLD)

Low level light therapy (LLT, laser therapy) for lymphoedema patients

Lymphoedema

North Devon Lymphoedema Service

Skin Care

Upper limb simple lymphatic drainage (SLD)