Leg ulcers – Legal implications of not referring

On Thursday evening (15th November), Prof Mark Whiteley gave a lecture about venous leg ulcers.

Prof Mark Whiteley giving lecture Legal implications of failure to recognise and refer patients suffering from leg ulcers – 15 Nov 2018 – Litfield House, Bristol

The title was “Legal implications of failing to refer leg ulcer patients for surgery”. He gave the lecture at Litfield House, Clifton, Bristol. Interested general practitioners from the Bristol area gave up their evenings to attend the talk.

Prof Whiteley presented the two patients featured in his book “Leg Ulcer Treatment Revolution“.

Both of these patients had suffered from venous leg ulcers for many years. The only treatment they had been offered was dressings and compression. They had not been offered endovenous surgery, despite the NICE guidelines and current research. Endovenous surgery has been proven to speed up the healing of venous leg ulcers. It also reduces the chance of them coming back.

Venous leg ulcer treatment.

Until the 1990s, treatment of venous leg ulcers was compression and dressings. In the 1990s, research showed that “hidden varicose veins” were the commonest cause of venous leg ulcers were usually caused by “hidden varicose veins”.

Local anaesthetic endovenous techniques successfully treat these “hidden varicose veins”. Typically these are the endovenous laser ablation, TRLOP closure of perforators and then foam sclerotherapy to follow.

Curing venous leg ulcers.

Prof Mark Whiteley giving lecture Legal implications of failure to recognise and refer patients suffering from leg ulcers – 15 Nov 2018 – Litfield House, Bristol

Research from the The Whiteley Clinic over 12 years has shown an 85% cure rate.

We achieve this by following the Whiteley Protocol. We use this protocol for varicose veins, venous leg ulcers, thread veins or pelvic congestion syndrome. The protocol addresses all forms of venous disease because it combines diagnosis with treatment.

We have developed the protocol from our own research over 20 years.

In July 2013, the National Institute of Health and Care Excellence (NICE) agreed with this general approach. They published clinical guidelines CG 168. Although related mainly to varicose veins, these guidelines include referral of any patient with a venous leg ulcer even if healed.

The guidelines state that all patients with venous leg ulcers need to be referred for endovenous surgery. This is the case even if the leg ulcer has healed. This is because endovenous surgery can reduce the risk of it coming back. If doctors or nurses fail to refer these patients, they are breaking NICE guidelines.

The simple book “Leg Ulcer Treatment Revolution” explains this fully. In addition, this book explains the three ways vein problems can cause leg ulcers. Most importantly it also explains how all of these can now be treated.