The Manchester Leg Circulation Service. An information guide

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1 TO PROVIDE THE VERY BEST CARE FOR EACH PATIENT ON EVERY OCCASION The Manchester Leg Circulation Service An information guide

2 The Manchester Leg Circulation Service Peripheral arterial disease Peripheral arterial disease is a narrowing, hardening or blockage of the main blood vessels in the legs. It reduces the blood and oxygen flow to your leg, which can result in aching or tightness in the calf or thigh muscles during walking; this is called intermittent claudication. Some people with reduced blood flow may not experience these warning symptoms. Peripheral arterial disease increases the risk of a heart attack, stroke and very rarely, leg amputation. Importantly - It can be successfully treated! If we find any reduction to your blood flow, we will explain what it means and what treatment is available. We will help you decide what to do next and then we will refer you to the relevant teams for treatment and support. Who are we? We are a clinical service that provides diagnostic assessment and treatment for adults who are registered with a Manchester GP, who have suspected peripheral arterial disease in the legs and feet. The team provides consultations at a choice of community clinics in the Manchester area where you will be seen by a specialist podiatrist or nurse, who have the knowledge and expertise in lower limb arterial disease. If your assessment shows that you have peripheral arterial disease, you will be offered the best treatment, which may include healthy lifestyle change support, supervised exercise, long term medicines and in severe cases a vascular surgical opinion to look at whether angioplasty or bypass operations may help. 2

3 To improve the quality of care and with your consent, information is shared securely between health and social care organisations involved in your care. Please let a member of staff know if you do not wish your information to be shared in this way. Please see our Trust website pages for further details How to access the service If you have been found to have signs of suspected peripheral arterial disease by any health professional you see, they will refer you to this service for further assessment. We will then contact your GP to authorise the referral and once confirmed you will be contacted by our service administrators, to offer you an appointment at any one of our clinics. You will be asked to bring a list of your current medicines and wear loose clothing, so we can check the circulation at your feet, knee, groin/hip, abdomen (tummy) and arms. What will happen during the first visit? The tests involve the use of a Doppler Ultrasound probe, which is an instrument that sends and receives sound signals to and from the blood vessels. The tests are non-invasive and usually painless. The tests A vascular-trained podiatrist or nurse will perform the tests. To get the best results you will be asked to lie down fairly flat on an assessment couch for between minutes. You may be asked not to talk at some points as it can affect the results. If you cannot lie flat, we will assess you semi-reclined. The pulses in your feet, behind the knees and in your groin will be felt for and listened to with the Doppler probe. The pulse of the main blood vessel (artery) in your abdomen may also be felt for, by 3

4 the clinician pressing down over your tummy area. A water-based, non-staining gel will be applied to your skin on your legs and arms to help the Doppler probe work. The blood pressures will be taken in both arms and both legs, using blood pressure cuffs and the Doppler probe. The test results will be used to help decide if you have peripheral arterial disease and whether any further tests, treatment or healthy lifestyle changes may benefit you. After the tests The podiatrist or nurse will explain the results of the tests to you. If you have any questions or concerns, please speak to the podiatrist or nurse and do not be afraid to ask. If you are found to have peripheral arterial disease, we will discuss and agree a treatment plan with you. This may involve lifelong daily medicines from your GP, support with healthy lifestyle changes, a supervised exercise programme or referral to see a vascular surgeon if you have severe or worsening circulation problems. We will send a letter detailing the results, clinical diagnosis and agreed plan to your GP, other relevant health professionals and yourself. Follow up visits If you are found to have peripheral arterial disease, you will usually be seen again between 3 and 12 months later, to review your condition, establish if it is improved, stable or deteriorated and then plan ongoing treatment, including further support for health changes if wanted. 4

5 Peripheral arterial disease is a lifelong condition which can be successfully controlled if treatment, advice and support for making health related changes are followed. Discharge If you are stable or improved, you will be discharged from our service, for ongoing monitoring by your GP, with the option for your GP to refer back to us again if needed. If your condition has deteriorated, we may refer you on to a vascular surgeon for a further opinion and to see if any surgical treatments may help, alongside the treatments mentioned above. Any surgical treatments would be explained to you by the vascular surgeon, if they were necessary or relevant to your condition. Contact details: The Manchester Leg Circulation Service Harpurhey Health Centre 1 Church Lane Harpurhey Manchester M9 4BE Tel no: Fax no: Opening hours: Monday - Friday 09.00am - 4:30pm 5

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8 If English is not your frst language and you need help, please contact the Ethnic Health Team on Jeżeli angielski nie jest twoim pierwszym językiem i potrzebujesz pomocy proszę skontaktować się z załogą Ethnic Health pod numerem telefonu For general enquiries please contact the Patient Advice and Liaison Service (PALS) on For enquiries regarding clinic appointments, clinical care and treatment please contact and the Switchboard Operator will put you through to the correct department / service Date of publication: November 2014 Date of review: April 2017 Date of next review: April 2019 Ref: PI_M_799 The Pennine Acute Hospitals NHS Trust Wood pulp sourced from sustainable forests