It has been identified that lymphoedema management services within the northern sector of the Metro North Hospital Health Service (MNHHS) were not being delivered to the same capacity as those in the southern sector. A consultation process including consumers, MNHHS staff, private service providers and non-government organisations (NGOs) identified that development of a clinical pathway in accordance with best practice models could assist with the provision of improved services to the northern sector. This informed the development of the MNHHS Lymphoedema Clinical Pathway Project. The pathway was launched in April 2016, with evaluation exempt from ethics review. It seeks to link patients more effectively with available lymphoedema management services and to improve the utilisation of primary care services instead of hospital based services. A government-funded program has increased the capacity for the identification and management of cancer-related lymphoedema within primary care. The pathway recommends that patients are screened for their risk of developing cancer-related lymphoedema and if risk is determined they are monitored by a trained GP. The GP then refers to a trained community health professional to manage this lymphoedema.
To date 37 community health professionals (GPs and practice nurses) have been trained in the early identification of lymphoedema. Results from training indicate a 3.3 point increase in self rated confidence and a 3.3 point increase in self rated knowledge levels (on a ten point scale) related to monitoring patients with risk for lymphoedema. 38 patients have been screened and assessed to have lymphoedema risk. NGO lymphoedema referrals have increased up to 161% since 9 NGO staff completed lymphoedema management training. The intended outcome of this pilot is a decrease in reliance on the hospital as the primary centre for lymphoedema management, with potential application to other clinical services.