Recommendations for system leaders/commissioners
- To commission lymphoedema at an STP level
- To ensure that this guidance is referenced in Sustainability and Transformation Plans (STPs) and that lymphoedema (both primary and secondary) is reviewed in each Integrated Care System (ICS) as part of managing cancer as a long-term condition.
- To ensure that there is better awareness of lymphoedema in primary care teams and that residents have equal access to lymphoedema services across London.
Recommendations for providers
- Continue to support their staff to participate fully in the Lymphoedema COP
- Ensure service users are central to all key decisions about their care, the principles of supported self-management are fully embedded in their services and that all patients have an individualised care plan. Signpost users to the online ‘Cancer Care Map’ as appropriate.
- Develop plans, where necessary with Health Education England, for workforce education and training and succession planning.
- Embed the lymphoedema minimum dataset as part of routine clinical practice
- Include lymphoedema management in Trust’s Cancer MDT Operational Policies.
- (NHS providers only) Ensure that ICD code I89.0 is used to record in-patient and outpatient lymphoedema activity and the appropriate ICD codes for cellulitis (a range exists dependent on the site of infection).
Recommendations for the third sector
- To promote this Guidance and work with the NHS to explore opportunities for enhancing services and patient care.
- To work with the NHS to consider educational initiatives to support workforce and service development e.g. funding lymphoedema development posts, training tissue viability/wound care staff in cancer care.
- To work with the NHS to help support awareness-raising and education on lymphoedema care within the wider workforce.