One in three people in the United Kingdom have varicose veins. Although many people have no symptoms, varicose veins do cause heaviness, throbbing, itching, cramps, restless legs, or tired legs. Varicose veins usually worsen over time and some people will go on to develop leg ulcers, which can be very difficult to heal and which significantly affect quality of life. The National Institute for Health and Care Excellence has recently made important recommendations, but will NICE really make a difference?
The new NICE guidance recommends that people should be referred to a vascular service if they have varicose veins causing symptoms, varicose eczema, phlebitis or leg ulcers. They should then have a duplex ultrasound scan to confirm what is wrong and then a plan should be formulated for treatment. The guidance goes onto recommend that endothermal ablation (treating the vein from the inside using heat energy from radiofrequency or laser) should be offered to treat confirmed varicose veins. Ultrasound-guided foam sclerotherapy should be offered to patients if endothermal ablation is not suitable. NICE recommends that only if neither treatment is suitable, should surgery be considered.
But is this happening? I know from feedback from varicose vein sufferers and from informal discussions with GPs that in many cases the NICE guidance is not being followed. GPs, specialists and patients are aware of the guidance but most people with varicose veins, even with complications such as phlebitis or varicose eczema, are simply not getting referred. They are not even getting to the hospital for an opinion or a scan. The reason — well I think it is about money and rationing. The NHS is under enormous financial pressure and my own personal opinion is that it cannot cope with the demand for venous disease treatment. The NICE guidance is just that — guidance and it is not being followed in many areas of the United Kingdom.
So far, the NICE guidance has made little difference since it was issued over 6 months ago.
Contact me today for a confidential chat
If you’re worried about your veins and would like a confidential chat please do get in touch. I am happy to offer simple advice by telephone or email for free and without obligation.
The VeinCare Centre also offers a screening assessment with our vascular technologist. For £25 you can have a scan with Wendy Parsons. She is not a doctor and so she could not give you medical advice but she can check your deep veins and your varicose veins and give you an idea of how bad they are and what treatment options might be available. If you would like to have an appointment with Wendy please call 0800 698 3467.