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A service development initiative to develop an expert lower limb group (ellg) across three hospital sites to improve lower limb care and patient experience.

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A service development initiative to develop an Expert Lower Limb Group (ELLG) across three hospitals to improve lower limb care and patient experience.

Elwell, Rebecca – University Hospital of North Midlands


To develop a trust wide ELLG of clinicians and associated services to develop 3 work streams; DVT, cellulitis and leg ulceration to streamline the patient journey.


A group of expert clinicians involved in the care of the lower limbs were invited to participate in an inauguration and mapping event from Jan to May 2015. Clinical representatives were present e.g. Dematology consultant, along with associated services e.g. stores/pharmacy and Trust managers e.g. Head of commissioning, Chief Nurse and Medical Director. A snapshot audit is planned to assess the number of patients with lower limb ulceration in the trust and DVT/cellulitis audits are being undertaken.

Evaluation, indicating any user involvement

A number of areas which required improvement were identified. Patient information leaflets have been developed, a business plan has been initiated for a new compression hosiery dispensary service which will allow patients to be measured and fitted with hosiery as prescribed by hospital staff. A leg ulceration pathway has been agreed to train all Health care workers (Band 3) to apply dressings and bandages once they have been assessed as competent and the patient has been seen by a seconded specialist ulcer nurse. A training package is currently being developed with the online college and a trust wide policy has been launched to ensure that all patients across the trust get lower limb washing and is being prospectively audited.

Although there is further work to do this initiative demonstrates how an organisation can truly demonstrate that it is clinically-led and can lead to improvements in patient experience.

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