Rehabilitation Pathways

(1)

Rehabilitation Pathways

MCCN Allied Health Professionals

Cross Cutting Group (CCG)

Author: Allied Health Professionals CCG Date Approved: 15 November 2010

Version: 1.1 Supersedes : N/A

(2)

INDEX PAGE

1.0 Introduction 3

2.0 Section One: Site Specific Rehabilitation Pathways

Brain/CNS 6

Breast 7

Colorectal 8

Gynaecology 9

Head & Neck 10

Haematology 11 Lung 12 Skin 13 Upper GI 14 Urology 15

Sarcoma ….to follow

2.0 Section Two: Locality Rehabilitation Directory

Eastern Sector 17

Liverpool 21

Sefton 23

Western Cheshire 25

(3)

1.0 Introduction

The development of tumour site specific Allied Health Professional (AHP) Cancer Rehabilitation care pathways is a requirement for Peer Review as part of the implementation of the Rehabilitation measures (2008). The aim of these pathways is to guide best practice and ensure appropriate service provision. Each care pathway should:

cover all stages of the patient’s journey from diagnosis through active treatment to survivorship and on to palliative/end of life care.

specify particular clinical indications for referral to each relevant rehabilitation service

describe the relevant intervention / procedure /therapy required from any or all of the four relevant AHP professional groups, i.e.

- Dietetics - Physiotherapy

- Occupational Therapy

- Speech & Language Therapy

link to the National AHP care pathways - the nine site specific pathways are: - Breast

- Head & Neck

- Upper GI - oesophago-gastric - Upper GI - hepatobiliary pancreas - Colorectal

- Urology - Lung - Brain CNS

Each of these has a drop down menu of appropriate common symptom pathways: - breathlessness

- Pain

- Lymphoedema

- Spinal Cord Compression - Continence

- Fatique and energy management - Anorexia/cachexia/weight loss - Dysphagia

- Communication difficulies

NB: for further information visit the National Cancer Action Team website or follow this link http://www.ncat.nhs.uk/our-work/living-with-beyond-cancer/cancer-rehabilitation

(4)

When a rehabilitation need is identified - consider the level of intervention required:

To make a referral to an AHP:

Please see your Local Cancer Rehabilitation Service Directory (see Section 2.0)

Is the symptom of little concern or already self adapted? Is the symptom impacting on function or quality of life? Encourage self management & offer supportive written information

NO YES

YES

Refer to Specialist Cancer AHP services who can offer expert advice, an

integrated care plan and ongoing support for future potential problems

Is the symptom likely to impact treatment options or become more debilitating over time? NO

Refer to symptom care pathway & consider referral to generic AHP

services for assessment and advice

YES

(5)

Section One: Site Specific Rehabilitation Pathways

- Brain & CNS - Breast

- Colorectal - Head & Neck - Haematology - Lung

- Skin - Upper GI - Urology

(6)

Clinical Indicators for Referral to Brain and CNS Tumour Rehabilitation Pathway:

http://www.cancer.nhs.uk/rehabilitation/documents/pathways/care_pathways/NCAT_Rehab_Brain CNS.pdf

Patients are at risk of developing or experiencing the following clinical indicators and should be assessed for referral to rehabilitation pathway interventions at all stages in the cancer care

pathway as described below: Diagnosis & Care Planning Treatment Post Treatment Monitoring/ Survivorship Palliative Care End of life Care •Breathing difficulties/cough •Pain •Sensory changes •Fatigue/tiredness

•Impaired balance and manual handling risk assessment •Equipment/information needs Consider level of intervention required:

• Information support

• General rehabilitation services

• Specialist oncology, neurology and palliative rehabilitation.

• Provision of information to support timely future access to rehabilitation services (see local cancer services directory: rehabilitation services).

Difficulties with activities of daily living (work productivity &

leisure):

•Functional impact of physical symptoms

•Functional impact of sensory changes

•Fatigue/tiredness

Nutrition and diet: •Altered appetite •Nausea and vomiting

Communication & Eating/Drinking:

•Food sticking in the throat

•Aspiration related chest infections Physiotherapy Occupational Therapy Dietitian Speech & Language Therapist

Difficulties with function,

movement and symptom control: •Difficulty with walking and getting around

•Upper and Lower Limb/Trunk weakness

•Changes with muscle tone, movement patterns and advice regarding positioning

•Weakness upper / lower limb or trunk

•Difficulty with functional mobility •Functional impact of anxiety and behavioural changes

•Cognitive and perceptual impairment

•Equipment/information needs

•Weight loss/Weight management •Fatigue/tiredness

•Difficulties swallowing •Information needs

•Weak or hoarse voice/Loss of volume

•Weak cough

•Difficulty understanding or speaking

(7)

Merseyside and Cheshire Cancer Network

Clinical Indicators for Referral to Breast Cancer Rehabilitation Pathway:

http://www.cancer.nhs.uk/rehabilitation/documents/pathways/care_pathways/NCAT_Rehab_ Breast.pdf

Patients are at risk of developing or experiencing the following clinical indicators and should be assessed for referral to rehabilitation pathway interventions at all stages in the cancer care pathway

as described below: Diagnosis & Care Planning Treatment Post Treatment Monitoring/ Survivorship

Palliative Care End of life Care

Difficulties with function, movement and symptom control:

•Upper Limb/Trunk movement disorder (especially post surgery/pre radiotherapy) •Difficulty walking and getting around •Fatigue/tiredness

•Pain

Consider level of intervention required:

• Specialist oncology/palliative rehabilitation.

• Ensure patient has contact details for timely future access to rehabilitation services (see local cancer services directory-rehabilitation services).

Difficulties with activities of daily living, leisure and work resulting from:

•Physical symptoms and changes in sensation

•Upper limb functional impairment •Fatigue or tiredness

Nutrition and diet:

Reduced appetite Weight loss/Weight management/weight gain

Lymphoedema: of upper limb, trunk or neck Physiotherap y Occupational Therapy Dietician Speech & Language Therapist Lymphoedema Specialist •Breathing difficulties/cough •Sensory changes

•Body image concerns

•Weakness (focal or generalized) •Impaired Balance

•Difficulty walking and getting around •Impaired balance

•Weakness •Anxiety

•Role and function change •Body image concerns •Cognitive impairment

•Equipment/information needs Fatigue/tiredness

Difficulties swallowing Nausea and vomiting Information needs

Impaired communication, eating and drinking:

•Coughing/choking on eating or drinking

•Aspiration related chest infections

•Weak or hoarse voice/Loss of volume •Difficulty understanding or speaking •Dry mouth

(8)

Clinical Indicators for Referral to Colo-Rectal Cancer Rehabilitation Pathway:

http://www.cancer.nhs.uk/rehabilitation/documents/pathways/care_pathways/NCAT_Rehab_C olorectal.pdf

as described below: Diagnosis & Care Planning Treatment Post Treatment Monitoring/ Survivorship Palliative Care End of life Care

movement and symptom control:

•Trunk movement disorder (especially post surgery/pre radiotherapy)

•Difficulty walking and getting around

•Physical symptoms and changes in sensation Functional impairment, (especially post surgery)

•Fatigue •Impaired balance •Weakness •Weight loss/Weight management/weight gain •Fatigue/tiredness •Difficulties swallowing •Information needs

Impaired or risk of impaired communication, eating and drinking:

•Food sticking in the throat •Recurrent chest infections ? Aspiration relate

Physiotherapy

Occupational Therapy

Dietician

Speech & Language Therapist

•Breathing difficulties/cough •Pain

•Sensory changes •Body image concerns •Fatigue/tiredness

•Anxiety

•Adjustment to role and function change

•Body image concerns •Cognitive impairment

•Difficulty understanding or speaking •Dry mouth

•Reduced appetite •Nausea and vomiting •Weak cough

(9)

Clinical Indicators for Referral to Gynae Cancer Rehabilitation Pathway:

http://www.cancer.nhs.uk/rehabilitation/documents/pathways/care_pathways/NCAT_Rehab_G ynae.pdf

•Lower Limb/Trunk movement impairment (especially

•post surgery/pre radiotherapy) •Difficulty walking and getting around •Incontinence

•Breathing difficulties/cough

•Physical symptoms/ sensory changes

•Lower limb functional impairment •Fatigue/tiredness

•Difficulty walking or getting around

•Reduced appetite •Nausea and vomiting •Fatigue/tiredness

Impaired or risk of impaired communication, eating and drinking:

Lymphoedema: of lower limb or trunk Physiotherapy Occupational Therapy Dietician Speech & Language Therapist Lymphoedema Specialist •Pain

•Body image concerns •Incontinence

•Sensory changes

•Impaired balance or weakness •Incontinence

•Concerns re: body image •Anxiety or cognitive impairment •Equipment/information needs

•Weight loss/Weight management/weight gain •Difficulties swallowing •Information needs

•Weak or hoarse voice/Loss of volume Weak cough

(10)

Clinical Indicators for Referral to Head and Neck Cancer Rehabilitation Pathway

http://www.cancer.nhs.uk/rehabilitation/documents/pathways/care_pathways/NCAT_Rehab_H eadAndNeck.pdf

Patients are at risk of developing or experiencing the following clinical indicators and should be assessed for referral to rehabilitation pathway interventions at all stages in the cancer

care pathway as described below:

Diagnosis & Care Planning Treatment Post Treatment Monitoring/ Survivorship Palliative Care End of life Care •Pain •Sensory changes •Body image concerns •Impaired Balance

•Equipment/information needs •Painful / stiff shoulder post op •Management of

secretions/tracheostomy e.g. post laryngectomy

•Recurrent chest infection

Difficulties with functional activities of daily living, leisure and work:

•Difficulty walking and getting around •Breathing difficulties

•Fatigue/Tiredness

•Impaired balance/weakness

•Reduced appetite (anorexia) •Malnutrition

•Weight loss/Weight management (cachexia)

•Aspiration related chest infections •Weak or hoarse voice/Loss of volume Physiotherapy Occupational Therapy Dietician Speech & Language Therapist

•Difficulty walking and getting around •Breathing difficulties/cough

•Tingling in hands and feet •Weakness and loss of muscle strength (focal or generalized)

•Anxiety/Depression/loss of motivation/isolation

•Adjustment to role and function change •Body image/ Facial disfigurement •Cognitive impairment

•Equipment/information needs •Tingling in hands and feet •Pain management

•Weak cough

•Difficulty understanding or speaking •Poor intelligibility/Sounding nasal •Stridor related to vocal cord problems •Dry mouth

•Laryngectomy care including surgical voice restoration, stoma care, heat moisture exchangers, use of or maintenance of artificial larynx

•Fatigue/tiredness •Nausea and vomiting •Difficulties swallowing •Information needs

(11)

(12)

Clinical Indicators for Referral to Lung Cancer Rehabilitation Pathway

http://www.cancer.nhs.uk/rehabilitation/documents/pathways/care_pathways/NCAT_Rehab_L ung.pdf

•Weakness and loss of muscle strength (focal or generalized) •Pain

•Impaired Balance •Sensory changes •Body image concerns

•Equipment/information needs Consider level of intervention required:

Difficulties with functional activities of daily living, leisure and work resulting from:

•Breathing difficulties •Fatigue/Tiredness

•Weight loss/Weight management (cachexia) Physiotherapy Occupational Therapy Dietician Speech & Language Therapist

Difficulties with function, movement and symptom control:

•Breathing difficulties/cough •Fatigue/tiredness

•Impaired balance/weakness •Anxiety

•Body image concerns •Cognitive impairment

•Equipment/environmental/information needs

•Weak cough

•Weak or hoarse voice/Loss of volume •Difficulty understanding or speaking •Dry mouth

(13)

Clinical Indicators for Referral to Skin Cancer Rehabilitation Pathway: (web address will be the MCCN location where the pathway is uploaded)

as described below: Diagnosis & Care Planning Treatment Post Treatment Monitoring/ Survivorship Palliative Care End of life Care •Breathing difficulties/cough •Pain/sensory changes •Fatigue/tiredness

•Weakness (specific focal or generalized)

•Impaired Balance

•Equipment/information needs Consider level of intervention required.

• Ensure patient has contact details for timely future access to rehabilitation services (see local cancer services directory: rehabilitation services).

•Physical symptoms and changes in sensation

•Limb/Trunk/Neck functional impairment

•Visual impairment

Nutrition and diet: •Reduced appetite •Nausea and vomiting

•Weight loss/Weight management

Communication & Eating/Drinking: •Food sticking in the throat

•Aspiration related chest infections •Weak or hoarse voice/Loss of volume

Lymphoedema of limb / trunk / head / neck Physiotherapy Occupational Therapy Dietician Speech & Language Therapist Lymphoedema

Difficulties with function, movement and symptom control:

•Limb/Trunk/Neck movement disorder (especially

•post surgery/pre

radiotherapy/consequent to scarring) •Difficulty walking and getting around

•Fatigue/tiredness/impaired balance •Weakness (focal or generalized) •Difficulty walking and getting around

•Anxiety/Cognitive impairment •Adjustment to role and function change •Equipment/information needs •Fatigue/tiredness •Difficulties swallowing •Information needs •Weak cough •Difficulty understanding or speaking •Dry mouth

(14)

Clinical Indicators for Referral to Upper GI Cancer Rehabilitation Pathway: http://www.cancer.nhs.uk/rehabilitation/documents/pathways/care_pathways/NCAT_Rehab_OesophGastric.pdf http://www.cancer.nhs.uk/rehabilitation/documents/pathways/care_pathways/NCAT_Rehab_HepatoPancreas.pdf

Consider level of intervention required: • Information support

• Ensure patient has contact details for timely future access to rehabilitation services (see local cancer services directory-rehabilitation services).

Physiotherapy Difficulties with function, movement and symptom control:

•Upper Limb/Trunk movement •Breathing difficulties/cough •Disorder (especially post surgery/pre radiotherapy) •Difficulty walking and getting around •Pain Occupational Therapy Difficulties with activities of daily living, leisure and work:

•Physical Symptoms •Sensory Changes

•Upper limb/trunk functional impairment, (especially post surgery)

•Fatigue/tiredness •Impaired balance •Weakness

•Sensory changes •Body Image Concerns •Equipment

•Information needs

•Anxiety

•Role and function change •Body image concerns •Cognitive impairment •Equipment needs •Information needs

Dietician

Impaired Nutrition & Diet:

•Reduced appetite •Nausea and vomiting •Weight loss

•Weight management/weight gain

•Fatigue/tiredness •Difficulties swallowing •Information needs

Speech & Language Therapist

Impaired

communication, eating and drinking:

•Weak cough

•Food sticking in the throat •Weak or hoarse voice/Loss of volume

(15)

Clinical Indicators for Referral to Urological Cancer Rehabilitation Pathway

http://www.cancer.nhs.uk/rehabilitation/documents/pathways/care_pathways/NCAT_Rehab_Uro logical.pdf

Patients are at risk of developing or experiencing the following clinical indicators and should be assessed for referral to rehabilitation pathway interventions at all stages in the cancer care

pathway as described below: Diagnosis & Care Planning Treatment Post Treatment Monitoring/ Survivorship Palliative Care End of life Care

•Weakness and loss of muscle strength (focal or generalized) •Incontinence

•Tingling in hands and feet •Sensory changes

•Body image concerns

•Equipment/information needs Consider level of intervention required:

•Breathing difficulties •Fatigue/Tiredness

•Impaired balance/weakness •Adjustment to role and function change

•Pain management

•Weight loss/Weight management (cachexia)

•Aspiration related chest infections •Food sticking in the throat

Physiotherapy Difficulties with function, movement and symptom control: Occupational Therapy Difficulties with functional activities of daily living, leisure and work:

Dietician:

Speech & Language Therapist: Impaired

communication, eating and drinking:

Lymphoedema Specialist Lymphoedema: of lower limb or trunk •Difficulty walking and getting

around •Impaired Balance •Breathing difficulties/cough •Fatigue/tiredness •Movement impairment/loss of function •Pain •Anxiety/Depression/loss of motivation/isolation

•Body image/ Facial disfigurement •Cognitive impairment

•Equipment/information needs •Tingling in hands and feet •Incontinence

•Weak cough

•Difficulty understanding or speaking •Dry mouth

(16)

Section Two: Locality Rehabilitation Directory

- Eastern Sector - Liverpool - Sefton - Western Cheshire - Wirral

Locality PCT Acute Trust/s Hospices

Eastern Sector o Halton & St Helens o Warrington o Knowsley o St Helens & Knowsley o Warrington & Halton o Halton Haven o ST Rocco’s o Willowbrook Liverpool o Liverpool o Royal Liverpool &

Broadgreen o Alder Hey*

o Liverpool Womens’ o Liverpool Heart &

Chest

o Marie Curie

Sefton o Sefton o Aintree

o The Walton Centre o Southport & Ormskirk o Woodlands o Queenscourt Western Cheshire

o Western Cheshire o Countess of Chester

o Hospice of the Good Shepherd Wirral o Wirral o Wirral Hospital

o Clatterbridge

o St Johns o Claire House* * Paediatric Services not included in this Directory

(17)

EASTERN SECTOR LOCALITY

NHS Halton & St Helens (Halton Service)

Service Clinic appointments available Patients Home Telephone Fax

Physiotherapy Yes Yes 01928 753467 01928 753887 Occupational

Therapy

Halton Haven & Home visits

Yes 01928 753571 01928 753264

Nutrition & Dietetics Yes Yes 01928 753202 01928 753411 Speech & Language

Therapy

Yes 01928 753424 01928 753313

Rapid Response Respiratory Team Physiotherapy

In & Out patients and home visits

01928 753165 01928 753888

Social Services OT Yes 01928 704463 01928 704547

NHS Knowsley (Knowsley & St Helens Services)

Service Clinic appointments available Patients Home Telephone Fax Physiotherapy- mobility: Knowsley No Yes 0151 244 3379 0151 244 3392 Physiotherapy- mobility: St Helens No Yes 01744 621 724 01744 621728 Occupational Therapy: Knowsley No Yes 0151 244 3379 0151 244 3392 Occupational Therapy: St Helens No Yes- rapid

reponse & re-enablement 01744 621724 01744 621728 Physiotherapy Musculo- skeletal Knowsley and St Helens Yes No 0151 430 1277

Nutrition & Dietetics Yes Yes 0151 290 4327 0151 290 4328 Speech & Language

Therapy

Yes Yes 0151 244 3385 0151 244 3392

Social Services OT No Yes 0151 443 4173

NHS Warrington Service Clinic appointments available Patients Home Telephone Fax Physiotherapy Orthopaedic Clinical Assessment and Treatment service Yes No 01925 251407 01925 251565

Community Falls & Rehabilitation

(18)

01928 753202 01928 753411 Speech & Language

Therapy

Yes Yes 01925 662062 01925 662923

Social Services OT Yes 01925 444239

St Helens & Knowsley NHS Trust: Whiston Hospital Service In-patient service

available

Telephone Fax Physiotherapy

Occupational Therapy Nutrition & Dietetics: Southport NHS Foundation Trust.

Speech & Language Therapy

YES for admitted patients.

0151 290 4133 0151 676 5860

St Helens & Knowsley NHS Trust: St Helens Hospital This is a DTC Facility only

Service Out-patient

service available

Telephone Fax

Physiotherapy No

Occupational Therapy No

Nutrition & Dietetics: No Speech & Language

Therapy

No

* St Helens and Knowsley NHS Trust Contracts In Patient services only (from NHS Knowlsey). Out Patient services are provided by NHS Knowsley for Knowsley and St Helens patients – see NHS Knowsley above.

Warrington & Halton NHS Foundation Trust: Warrington Hospital

Physiotherapy Yes In-pts:

01925 662992 Out-pts: 01925 662604 01925 662500 In-pts: 01925 662639 01925 275232 Occupational Therapy Yes In-pts:

01925 662992 Out-pts: 01925 662604

Nutrition & Dietetics Yes 01925 662459 01925 662923 Speech & Language

Therapy

Yes 01925 662062 01925 662923

Warrington & Halton NHS Foundation Trust: Halton Hospital

Physiotherapy Yes 01928 753236 None available

Occupational Therapy Yes In-pts: 01928 753571 Out-pts: 01928 753266 In-pts: 01928 753264 Out-pts: 01928 753118

Nutrition & Dietetics Yes 01928 753202 01928 753411 Speech & Language

Therapy

Yes 01928 753424 01928 753313

Rapid Response Respiratory Team

In-patients, out-patients and home

(19)

(physiotherapy) visits

Halton Haven, Runcorn

Service Home Visits In-patients Out- Patients & Day Therapy Telephone Fax

Physiotherapy Yes Yes Yes 01928 719454 01928 701201 Occupational

Therapy

Nutrition & Dietetics

Speech & Language Therapy No services available St Rocco’s, Warrington Service Home Visits In-patients Out- Patients & Day Therapy Telephone Fax

Therapy

Speech & Language Therapy No services available Willowbrook, St Helens Service Home Visits In-patients Out- Patients & Day Therapy Telephone Fax

Physiotherapy No Yes Yes 0151 430 8736 0151 493 1006 Occupational

Therapy

Yes Yes Yes 0151 430 8736 0151 493 1006

No services available

Wheelchair Services:

Service Telephone Fax

St Helens 01744 646 815 01744 458352

Halton 01928 582948 01928 582950

Warrington 01925 251445 01925 251446

Equipment Services:

Halton & St Helens 01744 676789

Knowsley 0151 289 6668 0151 292 7536/7537

(20)

Lymphoedema Service

Eastern – Halton & Warrington Warrington & Halton Hospitals NHS Foundation Trust 01925 662344 01925 662793

(21)

LIVERPOOL LOCALITY Liverpool PCT Service Clinic appointments available Patients Home Telephone Fax Physiotherapy No Yes 0151 296 7400 0151 283 3311 Occupational Therapy No Yes 0151 296 7400 0151 283 3311 Nutrition & Dietetics No Yes 0151 296 7400 0151 283 3311 Speech & Language Therapy

No service available for patients with cancer. Palliative non-malignancy related neurological conditions can be referred. Contact details as above.

Falls Service No Yes 0151 296 7400 0151 283 3311 Social Services

OT

No Yes 0151 233 3019

0151 233 3000

Royal Liverpool & Broadgreen Hospitals NHS Trust: Royal Liverpool Hospital Service Out-patient service

available

Physiotherapy: Yes 0151 709 2700 0151 709 5840 Occupational Therapy: No 0151 709 2700 0151 709 5840 Nutrition & Dietetics: Yes 0151 706 2120 0151 706 4638 Speech & Language

Therapy:

Yes (head & neck cancer only)

0151 706 2703 0151 709 5840

Royal Liverpool & Broadgreen Hospitals NHS Trust: Broadgreen Hospital

Physiotherapy: Yes 0151 282 6492 0151 282 6684 Occupational Therapy: No 0151 282 6492 0151 282 6684 Nutrition & Dietetics: No 0151 282 6473 0151 282 6477 Speech & Language

Therapy:

No 0151 282 6318 0151 282 6772

Liverpool Heart and Chest Hospital.

Service Out-patient service available

Physiotherapy No 0151 600 1953 0151 600 1659 Occupational Therapy Yes and home visits 0151 600 1956 0151 600 1659 Nutrition & Dietetics 0151 282 6473 0151 282 6477

No 0151 282 6318 0151 282 6772

Liverpool Women’s’ Hospital

Service Out-patient service available

Physiotherapy No 0151 702 4170

Occupational Therapy No service available

Nutrition & Dietetics As part of joint clinic 0151 702 1178 0151 702 4028

(22)

Day Therapy

Physiotherapy Yes Yes Yes 0151 8011468 0151 801 1458 Occupational

Therapy

Yes Yes Yes 0151 8011463 0151 801 1458 Nutrition & Dietetics

Liverpool 0151 296 7765 0151 296 7764

Liverpool 0151 282 7717/7718 0151 282 5180

Lymphoedema Services:

Locality Service Base Telephone Fax

Liverpool Liverpool Marie Curie Hospice Lymphoedema Service

(23)

SEFTON LOCALITY NHS Sefton: South Sefton Service Clinic appointments available Patients Home Telephone Fax Physiotherapy No Yes 0151 247 6113 0151 524 9750 Occupational Therapy No Yes 0151 247 6119 0151 524 9750 Nutrition & Dietetics Yes Yes 01704 383215 01704 383216 Speech & Language Therapy Yes Yes 0151 247 6110 0151 524 9750 Social Services OT No Yes 0151 934 3737

NHS Sefton: North Sefton Service Clinic appointments available Patients Home Telephone Fax

Physiotherapy Yes Yes 01704 385080 01704 385061 Occupational Therapy Yes Yes 01704 385080 01704 385061 Nutrition & Dietetics Yes Yes 01704 383215 01704 383216 Speech & Language Therapy Yes Yes 01704 385080 01704 385061 Social Services OT No Yes 0151 934 3737

Aintree Hospitals NHS Foundation Trust

Telephone Fax Physiotherapy Yes-

Musculo-skeletal.

0151 529 3355 0151 529 4982

Occupational Therapy No 0151 529 3910 0151 529 8086 Nutrition & Dietetics Some clinics

supported

0151 529 8588 0151 529 3748 Speech & Language

Therapy

Yes (head & neck cancer only)

0151 529 4986 0151 529 4989

Southport & Ormskirk Hospital NHS Trust

Service Out-patient service available Telephone Fax Physiotherapy Yes-musculo-skeletal only. 01704 704150 01704 704594

Occupational Therapy Splinting and acute musculo-skeletal

01704 704150 01704 704594

Nutrition & Dietetics: Southport NHS Foundation Trust.

No 01704 704938 01704 704878

(24)

available

Physiotherapy No 0151 529 5451 0151 529 5453 Occupational Therapy No 0151 529 5452 0151 529 5453 Nutrition & Dietetics Nutrition & dietetics and speech & language therapy services are

provided for in-patients only by the departments at Aintree Hospitals NHS Foundation Trust.

Queenscourt Hospice, Southport

Service Home Visits In-patients Out-patients & Day Therapy Telephone Fax

Physiotherapy Yes Yes Yes 01704

544645

01704 533655

Occupational Therapy Yes Yes Yes 01704 544645

01704 533655

Nutrition & Dietetics Speech & Language Therapy

Woodlands Hospice, Aintree Service Home Visits

& Community Outreach Service In-patients Out- Patients & Day Therapy Telephone Fax

Physiotherapy Yes Yes Yes 0151 529 2299 0151 529 2633 Occupational

Therapy

Yes Yes Yes 0151 529 2299 0151 529 2633 Nutrition & Dietetics Speech & Language Therapy No services available Wheelchair Services:

Sefton (includes Kirkby) 0151 529 3033 0151 529 3031

Sefton 0151 288 6208 0151 530 1203

South Sefton Woodlands Hospice Lymphoedema Service

0151 529 2299 0151 529 2633

North Sefton Ainsdale Centre for Health & Well-Being

01704 387164 01704 573929 (mark for attention of Lymphoedema Nurse)

(25)

WESTERN CHESHIRE LOCALITY NHS Western Cheshire Service Clinic appointments available Patients Home Telephone Fax Physiotherapy No Yes 01244 364866 01244 364868

Occupational Therapy No Yes 01244 364539 01244 364868

Nutrition & Dietetics Yes 01244 Speech & Language

Therapy

Yes 01244 650468

Specialist Palliative Care Therapy Team (Physio/OT)

No Yes 01244 364494 01244 364868

Countess of Chester NHS Hospital Trust Service Out-patient service

available

Telephone Fax Physiotherapy Yes- consultant

referrals only

01244 365207 01244365236

Occupational Therapy Yes- consultant referrals only

01244 365207 01244365236

Nutrition & Dietetics Yes- GP & cons referral

01244 365207 01244365236 Speech & Language

Therapy

Yes- GP & cons referral

01244 365207 01244365236

Hospice of the Good Shepherd, Chester

Service Home Visits In-patients Out- Patients & Day Therapy Telephone Fax

Therapy

Yes Yes Yes 01244 851091 01244 851108

Western Cheshire 0151 357 1070 0151 356 2984

(26)

Western Cheshire Clatterbridge Centre for Oncology: Lymphoedema Service 0151 334 1155 x4102 0151 482 7671

(27)

WIRRAL LOCALITY NHS Wirral Service Clinic appointments available Patients Home Telephone Fax Community Therapy Service

(Physiotherapy & OT)

No Yes 0151 488 7766

0151 488 3595

0151 488 7768 0151 488 3598 Nutrition & Dietetics Yes Yes 0151 604 7271 0151 488 7728 Speech & Language

Therapy

Yes Yes 0151 604 7714 0151 604 7280

Specialist Palliative Care Therapy Team: (physio, OT, dietitian)

No Yes 0151 328 0481 0151 328 0482

Social Services OT-: Birkenhead: Wallasey: Bebington & West Wirral: No Yes 0151 666 5060 0151 514 2183 0151 666 4933

Clatterbridge Centre for Oncology

(in & out-patient services available for patients receiving oncology treatments) Service

Telephone FAX

Physiotherapy 0151 334 1155 ext 4689 0151 482 7671 Occupational Therapy 0151 334 1155 ext 4844 0151 482 7671 Dietetics 0151 334 1155 ext 4297 0151 482 7671 Speech & Language Therapy 0151 334 1155 ext 4297 0151 482 7671

Wirral University Teaching Hospitals NHS Trust: Arrowe Park

Service Out-patient service available Telephone Fax Physiotherapy Yes 0151 604 7045 0151 604 7341 Occupational Therapy No 0151 678 5111 x8478 0151 604 7150

Nutrition & Dietetics Yes 0151 678 5111 x8145

Yes 0151 604 7714

Wirral University Teaching Hospitals NHS Trust: Clatterbridge Hospital

Service Out-patient service available Telephone Fax Physiotherapy Yes 0151 482 7776 0151 482 7628 Occupational Therapy No 0151 334 4000 x4730 0151 482 7730

Nutrition & Dietetics Yes 0151 334 4000 x

St Johns Hospice, Wirral

Service Home Visits In-patients Out- Patients & Day Therapy Telephone Fax

(28)

Therapy therapy=yes Out-patients= no

Wirral 0151 604 7261

0151 651 1630

0151 652 6799

Wirral 0151 334 9139 0151 482 8610

Wirral Clatterbridge Centre for Oncology: Lymphoedema Service 0151 334 1155 x4102 0151 482 7671

(29)

8.0 OUT OF AREA CONTACTS

8.1 Betsi Cadwaladr University NHS Trust Hospital

Service Contact Details

Lymphoedema Service Central: 01745 445225

West: 01286 662793 East: 01978 726257

Occupational Therapy Central: 01745 534268

West: 01248 384101 East:

01978 725412-in-patients 01978 29808-social services

Physiotherapy Central (Glan Clwyd):

01745 534043

West (Ysbyty Gwynedd) : 01248 384 100

East: (Wrexham)

01978 725408- reception 01978 727725- rehab unit 01978 725018 - community Speech & Language Therapy Central:

West: 01286 662760 East:

Dietician Central: 01745 534058

West: 01248 384103 East: 01978 727159

8.2 Christie NHS Foundation Trust

Service Contact Details

Lymphoedema Service 0161 446 3795

Occupational Therapy Department 0161 446 3795

Physiotherapy Department 0161 446 3795

Speech & Language Therapy 0161 446 8046