Publish date: 10 April 2026
To support better outcomes for our patients and create a more consistent experience across the Community Care Division, we are introducing a strengthened and standardised Lower Leg Pathway. This aligns with the National Wound Care Strategy and has been developed by Tissue Viability Nursing teams.
What’s changing?
From 13 April 2026, the previous Well Leg Service will be replaced with a clearer, more proactive discharge and prevention process. Please search ‘SOP CCD71’ on SharePoint for further details.
This approach ensures that all patients receive the same high‑quality support, regardless of where they live, and helps to reduce unnecessary appointments and long‑term follow‑up where this is no longer clinically required and discharged back to the care of the GP for ongoing preventative management.
The existing diabetic pathway is also being discontinued. Community Nursing teams are no longer required to routinely refer all diabetic patients regardless of HBA1c to Tissue Viability Nurses for Ankle Brachial Pressure Index (ABPI) and Toe Brachial Pressure Index (TBPI) assessment.
Instead, Community Nursing teams are expected to complete a comprehensive lower‑limb assessment, including ABPI, within their own clinical practice as per pathway. Referral to the TVN service should be reserved for patients with specific concerns, such as un‑occludable pulses or ABPI results that fall outside recommended guidance. However, if there are concerns regarding wound deterioration, non-healing or new lower‑limb symptoms, onward referral should continue as usual.
Changes are going to be introduced in phases and phase one will be initiated from 13 April onwards, and you’ll receive regular updates and resources as we move through each phase.
For further information and patient leaflets, visit Tissue Viability Service on YourSpace.
If you have any questions, please contact your local Tissue Viability Team within your local area:
Tissue Viability Liverpool and South Sefton
Phone: 0151 295 9415
Email: skincareservice
Tissue Viability Knowsley
Phone: 0151 351 8500
Email: knowsley
Tissue Viability Southport & Formby
Phone: 01704387210
Email: sftissueviabilityservice