Health CommitteeWritten evidence from British Lymphology Society (LTC 33)

British Lymphology Society (BLS) is the only UK wide organisation representing health care professionals and therapists treating Lymphoedema and associated conditions. We work very closely with the Lymphoedema Support Network which is a patient based organisation. We have seen the submission from Karen Friett, Chief Executive of the LSN and we fully endorse the information it contains about Lymphoedema and the views of the LSN as to steps which need to be taken to improve the situation. In addition BLS would make the following points:

Avoidance of Compartmentalisation

Lymphoedema is often associated with other co-morbidities. Patients often have to deal with the addition of diabetes cellulitis arthritis cardiovascular problems as well as obesity related issues, in the case of secondary lymphoedema patients—they may have to live with the devastating side effects of radiotherapy, or chemotherapy. These can include loss of function in the affected limb due to the damage of radiotherapy to the axilla (brachioplexus neuropathy).

In BLS’s view it is essential that a multi-disciplinary “whole person” approach is adopted. As with most long term conditions Lymphoedema does not fall neatly into a simple diagnostic or treatment methodology. We do not believe that concentrating on one type of long term condition, eg diabetes, is necessarily helpful.

Care Quality Commission

There are many centres who treat lymphoedema—NHS based services—hospice based services who are often only funded to see cancer patients, some services run by private practitioners, social enterprises, Any qualified providers (AQP) etc. BLS is currently in discussion with the CQC about the Registration requirements for private clinics and treatment centres providing lymphoedema services.

Whilst lymphoedema is clearly a long-term condition, the treatment needs of any one patient will vary from simple advice on the management of how to prevent the condition worsening, to the more intensive treatment of compression bandaging to reduce the size of a distorted, excess limb volume, maintaining with compression therapy, manual lymphatic drainage massage, and skin care to reduce the risk of cellulitis—and potentially surgical interventions such as liposuction. Some private service providers have been advised by CQC that since lymphoedema is a long term condition they must register.

Some private service providers have been advised by CQC that since Lymphoedema is a long term condition they must register. Whilst others have been told by CQC that the treatments they are providing are classed as complementary therapies and that they should not therefore be registered.

BLS would hope that this situation can be clarified urgently, and a consistent view provided by CQC.

It is essential that this condition is recognised and cohesive equitable services are encouraged to develop throughout the UK.

9 May 2013