Amputee rehabilitation unit (ARU)

Referrals

Making a referral

We accept referrals from consultants and GPs. We accept out of area referrals.

Before referring your patient, please read our admission criteria.

Please complete the ARU referral form only if it is a direct referral and not available on the NHS e-Referrals Service (e-RS).

(DOC 248.00KB)

You must state clearly the reason for referral, along with the:

  • 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 or signs
  • relevant medical history and any concurrent treatment
  • any transport or interpreter services required

Admission criteria

Rehabilitation admission criteria to the unit:

  • 18 years of age or over with a major lower limb or upper limb amputation, or both, or revision surgery
  • admission to ARU direct from a hospital
  • patient consents to admission to ARU
  • medically stable without risk of rapid deterioration
  • no regular acute or specialist medical/nursing input required
  • a minimum of 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 programme
  • patient centred achievable goals agreed with the patient and their carer and family
  • a discharge destination is identified on the referral
  • not awaiting planned surgery to the amputation stump
  • wounds must be sufficiently healed and stable margins for volume control rehabilitation to start. For example Juzo, PPAM Aid or Femurett (if referred for prosthetic rehabilitation)
  • able to bear weight on remaining or residual limb (if referred for prosthetic rehabilitation)
  • assessed for a wheelchair and onward referral made
  • MRSA, C. Difficile and 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 or other wounds, photographs are received alongside referral
  • plans in place for specialist follow up (for example, vascular, orthopaedic, plastic or podiatry) as required and ARU informed
  • Coronavirus (COVID-19) status/swab result and vaccination status received. Please check with the ARU for the most recent COVID-19 guidelines if this is applicable for your patient
     

Exclusion criteria:

  • patient does not consent for ARU transfer
  • a current problem with substance misuse for which treatment has not started
  • requires end of life hospice care
  • unstable behavioural, mental health or medical conditions which need specialist interventions
  • patients who are ineligible to receive NHS-funded rehabilitation care
  • no discharge destination address or discharge destination that is not safe or inhabitable
  • 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
  • where the local prosthetic centre does not provide ongoing prosthetic intervention if stump wounds are present (if referred for prosthetic rehabilitation)
  • long-term vacuum-assisted closure (VAC) therapy to stump wounds, this can be discussed on case-by-case basis
  • patient is in a social care bed to await ARU or has been discharged home, we're unable to admit patients from these locations

Last updated: March 2022

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