INTRODUCTION
In 2013, NICE published new guidance (CG168) for the management of lower limb venous disease; these guidelines sought to improve access to secondary care and recognised newer endovenous treatment modalities sufficiently robust to recommend. No formal study had evaluated the effect of the introduction of Guideline CG168 on venous disease management; this prompted the research project embodying this thesis.
METHODS
The management of venous disease was investigated locally at a secondary care level with primary care management being studied via the Health Improvement Network Database.
RESULTS
Local secondary care has improved significantly since the introduction of CG168, demonstrating an increased use of endovenous treatments at earlier stage of venous disease. A significantly higher number of patients are being referred for specialist review with leg ulceration.
An improvement in referral and management of varicose veins in the community setting was noted, however the increase in referral for leg ulceration was more modest, with patients often not referred at all for secondary care assessment.
CONCLUSION
Whilst current data presented here suggests enhanced management of superficial venous disease, nationwide primary care improvements have been less marked. Further efforts will be required to continue to publicise the importance of NICE Guideline CG168 in order to extend its beneficial effects on patient care
