Background Our comprehensive lymphoedema service supports primary, secondary and palliative lymphoedema, recognising long-term management striving to deliver seamless care between the primary and secondary settings.

Treatment incorporates a combination of elements, and while we carry out these specialist forms of treatment within our service, we understand that this is not achievable or sustainable in the wider community. Need is growing but the workforce is not.

Aims Through increased and innovative work with primary care the service aims to reduce the impact of lymphoedema and support management in community settings through a variety of partnership approaches, including:

• Staff rotational opportunities

• Early detection and prophylactic treatment.

Methods Recognising the demands on teams we have developed partnerships with acute and primary care settings and lead on-going education of health care professionals to consolidate their knowledge and skill base.

Two developing elements include:

A rotational post with the community allowing a nurse to spend time within our service developing lymphoedema management skills. There is potential to expand this further. Through securing substantive rotational posts within the community setting, we can consolidate their skill base and promote partnership and ongoing support for the long term care of patients.

Research indicates that within breast related lymphoedema, early detection can minimise the risk of long term complications and in some cases can reverse the clinical signs. Through close working with the local breast team detecting the presence of oedema before clinical signs are apparent, a reduction in patients developing symptomatic lymphoedema can be achieved.

Outcomes

• Improved outcomes for patients through sharing and developing skills across services

• Positive evaluation of prophylactic monitoring has the potential to be used with other diagnosed malignancies to reduce the incidence of long-term complications

• New ways of working with greater potential to develop optimal patient care through collaboration.