Outcomes from a proof-of-concept specialist lymphoedema clinic in the community

The Health and Safety Execultive lymphoedema model of care was published in 2018 highlighting the lack of dedicated lymphoedema services in Ireland. This led to the introduction of a proof-of-concept primary care specialist lymphoedema clinic. The clinic was responsible for all patients from their county. A comprehensive dataset was gathered which included the patient's history for 1 year prior to their presentation at clinic and then 6 monthly. A quality of life tool (LymQoL) and a patient satisfaction survey were completed. Completed 1-year data showed a significant reduction in GP and public health nurse visits as well as a reduction in the occurrence of cellulitis and associated hospital admissions. All areas of quality of life were improved and patient satisfaction was either excellent (89%) or very good (11%). The 1-year findings strongly support the roll-out of specialist clinics to all regional health areas.

[Specialist clinics - definition: proposal for the discussion from the ad hoc committee on care structures by the Association of the Scientific Medical Societies in Germany (AWMF) for the reform of hospital care]

Specialist clinics play an important role in inpatient care in the German healthcare system. They are characterized by a high degree of specialization and expertise and are described in numerous medical disciplines. However, a generally accepted legal definition of specialist clinics has so far been lacking. The ad hoc committee of the Association of the Scientific Medical Societies in Germany (AWMF) for the reform of hospital care in Germany, therefore, presents proposals for a definition, a description of quality characteristics, and an allocation to care levels. In the opinion of the committee, three aspects are necessary for the definition of specialist clinics: a high total number of patients treated, a high proportion of the disease entities attributable to the specialist area according to diagnosis and services, and structural characteristics. The definition proposed here is intended to help the political decision-makers in the federal and state governments to standardize according to medical-scientific criteria.