aaw pct local enhanced serviceaaw pct局部增强服务

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1、TheCausewayGoring-by-SeaWorthingWestSussexBN126BTPracticeName:PracticeAddress:SpecificationforaLocallyEnhancedService(LES)forthecareofpatientswithLegUlcers2008/09IntroductionAllpracticesareexpectedtoprovideessentialandthoseadditionalservicestheyarecontractedtoprovidetoalltheirpatien

2、ts.Thisenhancedservicespecificationoutlinesthemorespecialisedservicestobeprovided.Thespecificationofthisserviceisdesignedtocovertheenhancedaspectsofclinicalcareofthepatient,allofwhicharebeyondthescopeofessentialservices.Nopartofthespecificationbycommission,omissionorimplicationdefin

3、esorredefinesessentialoradditionalservices.BackgroundCurrentbestpracticeandnationalguidelinesrecommendtheuseofcompressionbandagingforpatientswhohavelegulcerationduetovenousdisease.Itisrecognisedthatthetreatmentofthisgroupofpatientsrequiresaspecialistlevelofknowledgeandskillandcanbet

4、imeconsuming.GPpracticeswillbeofferedpaymentfortreatingpatientswhohavelegulcerationwhichrequirescompressionbandagingviaaLocalEnhancedService.Practicesmayalsochoosetotakeadditionalpatientsfromneighbouringpracticeswherethisserviceisnotavailable,andreceivepaymentaccordingly.Aspartofthe

5、iressentialGMScontract,practicesshouldcontinuetoidentifyandprevent,asfaraspossible,thedevelopmentoflegulcersinallpatientsconsideredtobeathighrisk.Thiswouldincludepatientswithpreviouslegulcerhistory,varicoseeczemaandthoseforwhomelasticatedhosieryisbeingused.Treatmentshouldalsocontinu

6、eforpatientswithlegulcerationforwhomcompressiontherapyisnotasuitableoption.Staffshouldbeappropriatelytrainedtoundertakethiswork(seeaccreditationinformationbelow).ServiceoutlineTheaimoftheserviceistoappropriatelymanagethecareofpatientswithnewandexistinglegulcerationwhowouldbenefitfro

7、mcompressionbandagingtherapy.Theservicewillprovide:ØAfullandholisticassessmentofapatientwithlegulcerationtoassesstheirsuitabilityforcompressionbandaging.ThiswillincludetheuseofDopplerultrasoundasadiagnostictoolandscreeningfordiabetes.ØAnindividualisedtreatmentplanbasedonnationalguid

8、elinesandevidencedb