Coronavirus: amputee rehabilitation service update
In response to the coronavirus (COVID-19) outbreak, please read our advice and information before sending any referrals.
Who can refer
We accept referrals from consultants and GPs. Private referrals are not accepted.
How to make a referral
Please post or email your referral using the contacts at the top of this page. You must state clearly the reason for referral, along with the following information:
- patient's name, date of birth and contact details
- patient's NHS number
- patient's GP, including contact details
- a diagnosed condition and current clinical presentations/signs
- relevant medical history and any concurrent treatment
- any transport or interpreter services which may be required.
Rehabilitation admission criteria
The Amputee Rehabilitation Unit (ARU) is a 12 bedded unit, located at the Lambeth Community Care Centre, Kennington. The essence of the ARU model of care is to provide specialist amputee rehabilitation for people who have undergone major amputation. Rehabilitation is delivered over seven days to maximise patient outcomes and goal attainment.
The ARU brings together the essential elements of evidence based post-operative amputee care in an appropriately staffed and equipped specialist unit. Such elements include access to specialist medical, nursing, therapy and counselling professionals in amputee care. This facilitates early mobilisation, prosthetic provision and psychological care within a dedicated multi-disciplinary rehabilitation setting.
It’s important to note that the ARU is not staffed or equipped to offer support to medically unwell patients, those requiring non-specialist amputee rehabilitation or respite care or those waiting for a social services care package and discharge planning. The ARU is not a social care step down facility.
Decisions to admit to the ARU are made by the ARU multi-disciplinary team (MDT).
Rehabilitation Admission Criteria to the ARU
- 18 years of age or over with a major lower limb and/or upper limb amputation or revision surgery
- Admission to ARU direct from hospital setting
- Patient consents to admission to ARU
- Medically stable without risk of rapid deterioration
- No regular acute or specialist medical/nursing input required
- 10 days post major amputation surgery
- Diabetes controlled so there have been no hypoglycaemic events or hyperglycaemic events with BM>28 over the preceding 48 hours
- Assessed by therapists as ready to actively participate in rehabilitation
- Be predicted to cooperate with an intensive rehabilitation program
- Patient centred achievable goals agreed in collaboration with the patient and their carer/family
- A discharge destination is identified on the referral
- Not awaiting planned surgical intervention to the amputation stump
- Wounds must be sufficiently healed / stable margins for volume control rehabilitation to commence, e.g. Juzo, PPAM Aid / Femurett (if referred for prosthetic rehabilitation)
- Able to weight bear on remaining /residual limb (if referred for prosthetic rehabilitation)
- Assessed for a wheelchair and onward referral made
- MRSA / C. Difficile / Gram Negative up to date status received; admission determined by single room availability. MRSA swabs taken 48 hours prior to admission and ARU informed of outcome
- Access visit completed and report received
- For patients with a stump wound, photographs are received alongside referral
- Plans in place for specialist vascular / ortho / plastic etc follow up as required and ARU informed .
- Patient does not consent for ARU transfer
- A current problem with substance misuse for which treatment has not yet commenced
- Requires end of life hospice care
- Unstable behavioural, mental health or medical conditions which require specialist interventions
- Patients who are ineligible to receive NHS-funded rehabilitation care
- No discharge destination address/discharge destination that is not safe or in a state where habitation cannot occur
- Severe cognitive impairment, being unable to engage in the rehabilitation model.
- Unable to sit out of bed for a minimum of 1 hour, 3 times per day
- Does not require amputee specific rehabilitation
- Stump wound, where local prosthetic centre does not provide ongoing prosthetic intervention if stump wounds are present (if referred for prosthetic rehabilitation)
- Long Term VAC Therapy to stump wounds, stopping prosthetic rehabilitation progress (if referred for prosthetic rehabilitation).