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Venous disease


Minimum Referral Criteria

  • Category 1
    (appointment within 30 calendar days)
    • Haemorrhage from varicose veins
    • Venous ulcer
  • Category 2
    (appointment within 90 calendar days)
    • Acute thrombophlebitis (clexane for 6 weeks)
    • Lipodermatosclerosis
  • Category 3
    (appointment within 365 calendar days)
    • Symptomatic varicose veins impacting activities of daily living/work excluding cosmesis (Spider/cosmetic vein)

1. Reason for request Indicate on the referral

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can't order, or the patient can't afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

2. Essential referral information Referral will be returned without this

  • History and examination findings in particular commenting on:
    • bleeding venous ulcer
    • venous ulcer
    • thrombophlebitis
    • DVT
    • lipodermatosclerosis
    • varicose eczema
    • previous surgery
    • details how varicose veins limit activity (executing activities) and participation restrictions (involvement in life situations) e.g. standing long periods at work.
  • Conservative measures trialled
  • If peripheral arterial disease, please indicate if ulcers or ischaemic rest pain.
  • If history of DVT: ensure hypercoagulable screen and coag results

3. Additional referral information Useful for processing the referral

  • U&E, FBC results
  • USS mapping of varicose veins

4. Request

Last updated: 13 June 2023