I have suffered with a leg ulcer for many years and it can be challenging to try to navigate your way through the healthcare system and the myriad of different healthcare professionals who may be involved in your care. As a Patient Partner in the Legs Matter coalition, I have been involved in developing this list of clinical roles and responsibilities in simple terms and wanted to share it with you, in alphabetical order… Hope it’s helpful!
Advanced Nurse Practitioner (ANP) in GP practice
A nurse who has done additional training in advance clinical assessment skills who works in a GP practice. ANP’s assess and treat a wide variety of patients in a GP practice.
Advanced Clinical Practitioner (ACP) in a GP practice
A registered health professional who has done additional training in advanced clinical assessment skills who works in a GP practice. ACP’s assess and treat a wide variety of patients.
Community Nurse
A nurse who visits patients in their own home or residential care homes. The criteria for being referred to a community nurse is usually if someone is unable to leave the house (housebound). People who are able, should be seen by a practice nurse or leg clinic or leg club.
District nurse
The District Nurse leads a team of community nurses, and they usually see the most complex patients on the caseload. They coordinate complex packages or care for patients to enable them to remain at home. They will arrange referrals to the Tissue Viability Specialists.
GP
Your GP is a General Practitioner who oversees all aspects of your healthcare. They diagnose and treat a wide variety of clinical conditions but will seek advice from specialists when necessary. This will involve referrals to a specialist nurse or consultant, such as a Vascular consultant.
Health care assistant or clinical assistant
A clinician who is not a registered professional but works with the registered nurses in either the community nursing team or GP practice. They will undertake work delegated by the registered nurses which may include wound care and the application of compression therapy.
Lymphoedema nurse specialist
A nurse who has specialist training in the diagnosis and management of lymphoedema. This sometimes includes lipoedema. These nurses can be based in specialist clinics, hospitals, health centres or hospices.
Occupational therapist (OT)
Someone who works with people to improve their ability to perform daily tasks with the aim of them being more independent. OT’s use different therapeutic techniques and help people whose lives are impacted by physical health and / or mental health issues.
Outpatients nurse
A nurse who works in any outpatients’ department in the hospital. Outpatients is where clinics are held, where patients come in from home for appointments then return home.
Pharmacist
Community pharmacist
A pharmacist who works in a high street chemist. They can provide advice and signposting on a range of clinical conditions. They may also provide hosiery advice and measurement.
Hospital pharmacist
A pharmacist who overseas your medication while in hospital. They may make some changes to medications or advise your medical team, but only during your time in hospital.
Physiotherapist (physio)
Someone who aims to improve your physical function and independence. This involves assessing movement and strength and developing a programme of exercise.
Plastic surgeon
A surgeon who specialises in the reconstruction of defects. Plastic surgeons do skin grafts and other types of complex reconstructive surgery to cover wounds.
Podiatrist
A podiatrist is a professional who looks after problems with the foot, such as nail problems, callus, corns, verrucae, skin problems, posture, gait. A podiatrist can also treat a patient with a diabetic foot ulcer.
Podiatry is different to chiropody in that podiatrists qualify with a degree and can then go onto further study or surgical exams to become a podiatric surgeon.
Even within the small field of Podiatry, the clinicians specialise, some in biomechanics, some in diabetic foot care for example.
Practice nurse
A nurse who works in the GP practice. They will provide wound care or oedema assessment and refer on to Tissue Viability Specialists. They may support you will self-management.
Tissue viability nurse (TVN)
A nurse who is a specialist in wound prevention and management. A TVN can be based in a hospital or in the community. Many clinicians can, and should, refer non healing wounds to a TVN. Patients without wounds can be referred to a TVN if they have more complex needs or if the generalist clinician needs advice and support.
Vascular nurse specialist
A nurse who is a specialist in the circulatory system. As such, they often manage complex leg ulcer patients. They work closely with vascular surgeons. You would see a vascular nurse as part of a general referral to ‘Vascular’ which usually means the Vascular team (nurses, specialist nurses, and surgeons). Patients with leg ulcers should be referred by the GP to the vascular team for as assessment of the veins and arteries to see if there are any suitable interventions which may improve the flow of blood through the veins or arteries.
Vascular surgeon
Vascular surgeons diagnose and manage conditions affecting the circulation, including disease of the arteries and veins; their advice may be sought on the suitability of compression therapy. They treat all parts of the vascular system apart from the heart and the brain.
Additional resource
We also have a full glossary of medical terminology.
