SMASAC Short Life Working Group on Lymphoedema - Lymphoedema Care in Scotland, Achieving Equity and Quality

Appendix 2: Additional Epidemiological Data

Table 1 below shows Scottish hospital data for admissions with lymphoedema as the main diagnosis in calendar years 2002-2010.

Table 1. The number of hospital episodes for lymphoedema by NHS Health Board and Scotland level, calendar year 2002 - 2010

Source: SMR01 (ISD Scotland) discharges from non-obstetric/non-psychiatric NHS hospitals in Scotland.

ICD10 codes for lymphoedema: I89.0, I97.2, Q82.0 in any diagnosis position.

The average length of stay was 8.59 days per person (range 1-287).The admission numbers recorded are considered an underestimate as poor diagnostic coding and poor awareness of the condition may omit many patients from these figures. The current cost per in-patient bed day is calculated at £491. Using this figure an estimate of costs in 2010/11 (1,436 bed days in total) can be calculated at a minimum of £705,076.

Table 2 below demonstrates variation in specialist staffing levels by health board. Some Health Boards provide services only for people with cancer related lymphoedema, whilst others provide a full service for all types of lymphoedema. Clinics range from lone part-time practitioners to small multidisciplinary teams and are based within palliative care centres, cancer clinics, physiotherapy departments, hospital and community based clinics. Referral pathways to services differ between Health Boards as do assessment processes and the co-ordination of treatment pathways.

Table 2. Specialist Lymphoedema Practitioners by Health Board Area

* Figures supplied for Strathcarron Hospice, Denny.

** In addition, there are two non-funded ad-hoc services identified at Ayr Hospital and Ayr Central Hospital.

*** Obtained from analysis undertaken by Sneddon et al, 2008.