2.  Since 2009, funding for varicose vein surgery has been rationed by our local PCT.  Currently, we are able to treat patients with a CEAP classification of 5 & 6 only.  This means, individuals with severe skin staining, pre-ulceration, ulceration or significant bleeding from the vein.

3.  As a trust, we currently receive approximately 15-20 referrals per week for varicose vein management.  Prior to rationing, symptomatic patients would have been offered intervention.  Approximately, only 5-10% of those patients referred via GPs are actually suitable for treatment using current rationing guidelines.

4.  Compression stockings  Foam Sclerotherapy  Radio Frequency Ablation  Surgery

5. GP VASCULAR TEAM HOME ORTHOTIC TEAM HOME ORTHOTIC TEAM EVENTUALLY HOME WITH A PAIR OF STOCKINGS!

6. GP VASCULAR TEAM HOME o History & Examination o Measure o Fit stocking o Take payment o Copy of prescription to GP

7.  Budget  Training  Orthotic workload  Payment  Stock – ordering / storage  Time constraints  Single site / both sites

8.  Quotations from different companies  View available stock  Negotiate price  Organise consignment stock  Storage  Meet with Pharmacy re: payment  Organise training  - Team  - OPD Staff members

9.  Improve patient journey – delivering a more efficient, time effective service  Fewer appointments utilised  Patients receiving treatment immediately  Patient not travelling back and forth  Better purchasing freedom