15 February

    Customer partnership – Justine Whitaker

    wound manager, director and head of nursing at the Northern Lymphology Clinic in the UK, university lecturer

    I am a real working mum. My day started 2 hours ago: I had my first coffee of the day and woke up the children for their school day. Now it’s my chance to nip into the field at the bottom of the garden and walk along the river with our family dog before my husband and me go to work.

    Now at work at the clinic (Northern Lymphology Ltd.), before I start preparing for the day of patients arriving: a selection of patients coming for various treatments with various types of Lymphoedema...

    ...My first patient, 54 years old, a Naval Veteran with Bilateral full leg stage 3 lymphoedema. His legs have been pouring large amounts of lymph fluid for over eight months. His quality of life has diminished at a fast rate, resulting in him losing his job. Before he arrives I set out all the bandages and dressings I plan to use on him today....

    ... I stopped the lymph leakage of my 54 yea-rold patient literally overnight using a system to do both legs that not only delivers excellent results on patients with late stage 2 and stage 3 lymphoedema, but also enables him to remain mobile and safe: Against the area which leaked I place a nonadhesive Flivasorb, then bandaging his toes with Mollelast, I progress up the limb from the foot to top thigh with Rosidal soft. Over the top of this I apply Actico Cohesive bandage in a figure of eight application. ...

    ... It’s very emotional when a patient hasn’t been able to do something for over eight months at home and now he has the opportunity to do so, e.g. to simply being able to wash. I feel so blessed that my clinic offers one of life’s basic needs through my treatment concepts, vital for the overall approach to individualised care. After that, during the MLD and Intermittent Pneumatic Compression session, me and my patient enjoy learning about each other’s life styles. This one-to-one time helps me to plan ongoing care which is tailored to him as an individual. It’s an art as the patient doesn’t know I am doing this consciously. After half an hour of measuring the intensive phase is complete. Bandages on, giving instructions, the gentleman leaves....

    ...I love getting to know people and find their life stories humbling and I know when I have this uniform on … I am in a very privileged position! Even after a full day, I sometimes make myself a cup of de-caffeinated Earl Grey Tea and switch on my laptop again, e.g. to just doublecheck a couple of sessions before my students arrive. I run an Advanced Certificate in the management of chronic oedema at the University of Central Lancashire (Uclan), Preston, UK, as a Senior Lecturer one day a week. Again a very privileged job to being able share the many years of experience and knowledge with the next generation of nurses and physiotherapists who want to learn how to manage lymphoedema....

    ...Lunch Break. 45 minutes time to have my second cup of coffee, have a quick cheese toasty and a banana, replying emails and making phone calls. Quick phone call to Richard, my husband and Financial Director of Northern Lymphology, to share my news and making sure he will be looking after the children. Back into clinic....

    After the lady has had a Mastectomy for Breast Cancer, she has now developed lymphoedema of the arm. In one and a half hour I explain to her in detail why it occurs, how we can manage it but also that it is a lifelong condition. I try very hard to support her by sharing with her some positive experience. We discuss treatment options and start with a circular knit combined armsleeve. MLD sessions will start next week. One week – not only to get the sleeve, but also for her to change her way of thinking into a positive mindset.

    The Healthcare System in the UK

    The National Health Service provides free health care throughout the United Kingdom. Brits can be pleased that they are essentially able to enjoy free health care treatment, although they also have to accept long waiting times before they are able to get an appointment and receive subsequent treatment. Simon Stevens, Head of the NHS England, has developed a five year plan in order to implement his vision: an integrated, personalised and cost-efficient system for providing healthcare treatment.

    The Plan:

    • Make massive investments in the prevention, public health and in the selfmanagement of patients
    • More emphasis on patient care at the local level
    • Better networking of medical personnel and the providers of treatment


    • 9.3 percent of GDP is invested in the healthcare sector; according to an OECD comparison, this is only an average value – in many other European countries, a higher percentage of the economic product is invested in health care
    • Since the year 2000, more medical personnel are being trained and the access to care has improved
    • In 2015, there were 2.8 doctors available per 1,000 inhabitants; in the year 2000, this figure was just 2.0 doctors per 1,000 inhabitants
    • There are 8.2 nurses per 1,000 inhabitants; in an OECD comparison, this figure is 8.8
    • The hospitals leave a more sobering impression: There are 2.8 hospital beds per 1000 inhabitants – the OECD average is about 4.8