• A referral should be made when the implemented treatment plan, based on a holistic wound assessment, is not achieving the desired outcomes.
• The clinician is expected to of followed the relevant frameworks in place prior to a referral and to have discussed the treatment plan with a senior clinician within their team.

Pressure Ulcers

1. Category 3 and above to support assessment and management if specialist advice needed.
2. Lateral turning system authorisation
3. Complex symptoms such as infection, pain or exudate.

• Leg Ulcers

1. Management – Leg ulcers that have failed to progress following 12 weeks of optimum treatment.
2. Complex symptoms such as varicose eczema, hyperkeratosis, pain and exudate.

• Lymphoedema – if active leg ulceration.
• MASD – Severe if failing to resolve following MASD pathway.
• Advanced therapy – such as NPWT or Larvae therapy – Tissue Viability will provide education and support.
• Non-healing surgical wounds.
• Referrals from Podiatry for foot ulceration.
• Fungating Wounds – Complex symptom management.

• If the patient is already under another specialist service, then contact should be made with them in the first instance.
• Pressure Ulcer – Category 1 and 2
• Ordering equipment.
• MASD – Prevention, Mild and Moderate.
• NPWT – Routine referrals – acute trust issued, unless clinical/training reason.
• Oedema management
• Lymphoedema
• Dermatological conditions
• Foot Ulceration – Anything below the malleolus is to be referred to Podiatry.