Lower Limb Pathway Referral Guidance


Vicky Storey, Senior District Nurse has shared the updated Lower Limb Referral Pathway Guidance and the Lower Limb Clinic Referral Form for the benefit of GPs in the area. The forms are downloadable from this page. 

A brief summary of the Referral Pathway is found below: 

Lymphoedema Specialist Team  

  1. Presence of oedema (after excluding DVT if indicated and appropriate investigations to consider presence of organ failure)
  2. Episodes of recurrent cellulitis 
  3. Chronic lymphoedema 

ACTION: Send referral form to Beechwood Community Health Centre. 

Leg Ulcer Clinic/District Nurses

  1. Open lesion between the ankle and knee, not healing after 2 weeks. 
  2. A lower limb wound that falls outside the field of knowledge of the practitioner
  3. Presence of varicose veins where the patient does not wish to pursue invasive treatment
  4. Persistent episodes of varicose eczema and other indications of venous hypertension 

ACTION: Send referral form to lower limb clinic co-ordinator. (see downloadable form) 

Vascular Clinic 

  1. Arterial Symptoms 
  2. Absent foot pulses - symptomatic i.e. claudication or ulceration 
  3. Intermittent Claudication 
  4. Varicose veins 
  5. Critical Limb Ischaemia (Urgent Referral) 

ACTION: Send referral form to vascular secretaries.

Urgent referrals email to Kate Humphries and Fax to Vascular. 

Podiatry Department 

  1. Foot ulceration 
  2. Toenail problems 
  3. Diabetes 
  4. Musculoskeletal foot changes 
  5. Callouses / corns
  6. Pressure relief / offloading 

ACTION: Send referral via Systm1 task to podiatry admin. 



Published date 26th March 2018