Tissue Viability Information & Referrals

Who are we and what do we do?

Tissue Viability is a nurse-led speciality that provides expert knowledge and skills to support staff and adult patients in the prevention, diagnosis and treatment of a wide range of wounds and skin integrity concerns. The Tissue Viability Nursing (TVN) team work with all social and healthcare staff, patients/residents and their families to improve quality of life and achieve person centred goals.

The speciality covers all aspects of complex wounds such as risk assessment, pain control, odour control, nutrition, reduced mobility and advice on specialist equipment. We can offer advice and recommend suitable treatments including advanced interventions and therapies. We provide educational teaching sessions internally and organise external staff training also.

How to Refer to Tissue Viability

Use the below chart to guide on if you can direct refer or not, if you can direct refer you should have received a resource box with everything that you will need for the referral process.

Choose the correct drop down below to find information on how to refer:

Care Home with Registered Nurses and Secure Email

Things to Do Before you Refer:

A full holistic assessment and determine a diagnosis for the wound e.g. Pressure Ulcer, Leg Ulcer etc.
Consider the cause of the wound and address any underlying issues e.g. Obtain pressure offloading products for a pressure ulcer.
Complete a wound assessment and apply the correct dressings from the East Region Formulary : Formulary | East Region Formulary (nhs.scot)
Use 9 step guide to ensure that you have optimised the wound healing, the guide is located here: 9 Step Guide

E-Wound Clinic Referral:

If you have completed the above steps and the wound is still not healing then refer to the E-Wound Clinic. You must include the below items and email your referral into the clinic, we will not accept phone call referrals or emails to individual TVN’s email addresses . Referrals that are not complete will be bounced back and may delay the referral process so please ensure that the steps are followed fully.

You will need:

A completed referral form located here: REFERRAL FORM
Medical Photography consent form located here: CLINICAL PHOTOGRAPHY CONSENT
A minimum of two photographs of the wound, one should be a close up of the wound and the other should be a wider picture of body area that the wounds is on. Please ensure these are taken on the camera that has been provided and not a personal device. For guidance on use of the camera and uploading to your email please see: E-CLINIC GUIDE
Ensure that you attach all of the above items to your email.
Write ‘Care Home Referral’ in the subject line and email to ewound.clinic@nhslothian.scot.nhs.uk, you will receive a bounce back email from the clinic to confirm it has been received.

Care Home without Registered Nurses and/or without Secure Email

If you are a Care Home with no Registered Nurses and you feel Tissue Viability is required then please contact your District Nursing Team or Care Home Support Team who will complete the relevant referral forms.

If you are a Care Home with Registered Nurses and are not yet on a secure email please continue to refer via your District Nursing Team or Care Home Support Team until your email is secure. Any referrals received from non-secured email addresses will be not be actioned due to data protection. For more information on Secure Emails please see the Secure Email Accounts page.

Frequently Asked Questions

I am not sure how to complete a referral, what do I do?
- See information above or in your referral box provided by TVN
What do I do if I can’t open the form or complete it electronically?
- Please contact eWound clinic for PDF version, print and scan to send back to clinic.
Can I refer to TVN?
- Yes if you are a care home with registered nurses and on the secure email list.
- No if you are a care home without registered nurses or not on secure emails, refer to your DN/CHST.
Who should I refer to TVN?
- Please see the chart above on who to refer and who not to refer.
What if my referral is urgent? Can I phone for advice?
- The TVN team are not an emergency service, all referrals and queries should be sent via email. The tissue viability service provision is Monday to Friday 08:30-16:30 excluding public holidays. If you feel you require support urgently please contact your local GP or CHST/DN team in the first instance and refer as per pathway.
My resident has a wound infection, what do I do?
- Contact the GP/CHST that provide medical cover within your home for advice.
Can I ask the TVN to review another resident when they are in the care home without prior referral?
- No, all residents should be referred via the referral pathway to ensure appropriate triage and history is obtained prior to review.
Will the resident be routinely followed up?
- No, a treatment plan will be provided either after a home visit or via email by a senior TVN based on the e-clinic photographs. This will clearly state whether a follow up is planned or not.
- It is the registered nurse within the care homes responsibility to review and assess the wounds after treatment plans have been given. Should further support be required after 14 days please complete a new referral with updated photographs.
What if I run out/can’t access the dressings recommended?
- Contact the pharmacy allocated to your care home to enquire if there is a shortage or issues with supply.
- Contact your GP/CHST who would routinely prescribe dressings that have been requested if you have run out or have not received those requested.
- TVN do not supply or prescribe the dressing stock, it is your responsibility to arrange this and follow up any concerns.
What do I do if I need equipment?
- Follow the process within your care home, TVN do not supply or organise equipment.
I can’t find the camera to refer, what do I do?
- Check within your care home to ensure that someone hasn’t misplaced it. If the camera is missing it is the care homes responsibility to replace it, TVN will not provide a second camera.
- If you lose the camera, you cannot refer via the e-clinic process so would need to liaise with your DN/CHSTs to organise referral.

Formulary Information – Wound Dressings

If you are choosing dressings please see the East Region Formulary for guidance on what to use: find out more about the updated formulary.

The Care Home Prescription Request Form has also recently been updated in line with the East Region Formulary.