Pre-operative phase

• Patient identified for amputation by consultant, or vascular nurse, in clinic or other hospital. (Patient has no revascularization options).

• Referred to amputation MDT (fhft.vascularamputeephysiofph@nhs.net)

• Pre-op amputation MDT carried out, within a timely manner and a period of optimisation if necessary, including discharge planning and medical optimisation. Care pathway commenced.

• Refer to Vascular Anaethetist.

  • If patient is diabetic, to be reviewed pre-operatively by the specialist Diabetes team to optimise control of diabetes and management of co-morbidities. If recent HbA1c elevated

• Place on planned consultant list and pre-assessment clinic carried out. MRSA screening (DoH)

• Admit on elective list with a named consultant

  • Reviewed by Vascular Anaesthetist for optimisation and post-operative level of care

  • Consent

  • Review by MDT (pain team, PT, OT, diabetes)

  • All pre-op assessment completed, (falls, nutrition, (NICE), pressure areas)