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Challenges and opportunities identified for lymphoedema services in Wales during the COVID-19 pandemic

25 February 2021
Volume 30 · Issue 4



During the COVID-19 pandemic, lymphoedema staff adapted services, providing care remotely, and worked in other NHS sectors. The impact on services and staff must be understood in order to safeguard patient care and foster workforce resilience.


To evaluate the experiences of clinical and non-clinical lymphoedema staff in Wales during the COVID-19 pandemic.


An anonymous online survey, based on scoping work, was sent out via the Welsh lymphoedema services mailing list.


71% (68/96) of eligible lymphoedema staff completed the survey. More than half supported lymphoedema services (40/68) with the remaining staff deployed elsewhere. Overall, staff and services felt prepared for new ways of working. Concerns about others and the future burden on services when life returned to normal were reported. Opportunities identified included education initiatives and virtual services.


Lymphoedema services were well prepared to deliver virtually, enable effective care and share knowledge. Co-ordinated efforts to uphold patient advocacy will support virtual services to meet their needs.

During the COVID-19 pandemic, global health services have endeavoured to limit transmission and prioritise access to urgent care. This presented a challenge to the ongoing management of long-term conditions, including lymphoedema care. Damage to the lymphatic system can cause chronic swelling and a myriad of problems for patients that affect their health, wellbeing and quality of life (Greene and Meskell, 2017; Todd, 2017; Mercier et al, 2019; Thomas et al, 2020).

In addition to patient stories, lymphoedema therapists typically rely on sensory data (visual and tactile information) to assess lymphoedema and plan care. However, the COVID-19 pandemic curtailed face-to-face appointments and led to access being rationed according to urgency of need. In response, virtual lymphoedema services were implemented; however, the impact on access (delayed appointments and referrals) and lymphoedema management (risk of deterioration as well as postponed intensive treatments) was unclear.

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