DCHS Wound Clinic offers out-patient, appointment based, wound care for hard-to-heal, chronic, or complex wounds for those 18-years or over (adults) who are non-housebound.
dchst.woundclinic@nhs.net (please allow 5 days for a reply)
Central Phone Number: 01332 267977 (Monday to Friday, 08:30 to 16:30)

1. Complete Wound Clinic Referral Form
2. Refer to DCHS Wound Clinic Service
   • Remember to select the appropriate team
3. Check Record is shared out
4. Attach photos if available

• Registered with a Derby City or Derbyshire GP.
• Adults aged 18-years and over.
• Hard-to-Heal Wound (previously named 'Complex Wound') which is:
  • Static of 4 weeks duration or not likely to heal in 4-6 weeks. If a wound is likely to heal at week 5 or 6, this should stay with the GP.
  • Leg ulceration on identification (i.e., venous, suspected venous, leaking legs, ischaemic).  
  • Deteriorating wound (i.e., increasing depth or size, infection, necrosis) (Note to referrer: Ensure that wounds with infection or suspected infection receive appropriate antibiotic therapy at the point of identification).
  • Heavily exuding wound that requires daily dressing due to exudate level.
  • Deep wound (penetrating to bone, muscle, or tendon) or where tunnelling or undermining extends beyond 2cm.
  • Fungating wound (Note to referrer: Palliative or end-of-life wound care may best be managed at the patient's home by DCHS Community Nursing with consideration of the patient's wishes and ability to attend clinic).
  • Wound with unusual presentation or features (Note to referrer: Consider early biopsy/referral to Dermatology).
  • Pressure ulceration category 3, 4, and unstageable or Suspected Deep Tissue Injury (SDTI) that ulcerates or where underlying structures are visible or palpable (Note to referrer: Pressure ulcers are likely to heal once offloaded. Ensure off-loading is optimised on immediate presentation at GP Practice).
• Surgical Wound which is:
  • Not likely to heal in 4-6 weeks due to size, complexity, or complication(Note to referrer: Non-healing post-surgical wounds in the first 6 weeks post-surgery must be referred back to the surgical team for consideration of surgical site infection (SSI) due to national reporting requirements on identification by the GP).
  • Cavity wound that requires packing that is deeper than 5cm or when tunnelling or undermining extends beyond 2cm. If a wound is penetrating to bone, muscle, or tendon this should be referred(Note to referrer: For all cavity wounds not meeting this criteria, GPs to consider supported patient self-care and non-daily dressing options; seek DCHS Tissue Viability Support if required).
  • Negative Pressure Wound Therapy (including PICO)(Note to referrer: This must be referred to the DCHS Tissue Viability Service who will direct care).
• Foot Wound which is:
  • In a patient that requires (or is suspected of requiring) lower limb compression therapy (bandaging) or extends past the level of the ankle(Note to referrer: If unsure that compression is required, refer to the DCHS Wound Clinic Service).

Patients with active diabetic foot disease (ulceration, Charcot Neuroarthropathy (red, hot, swollen foot), infection) should ALSO be referred to the local multidisciplinary Diabetic Foot Team at identification according to local arrangements in line with NICE Guidance AT THE SAME TIME as the Wound Clinic Service referral. 

• Patients not registered with a Derbyshire GP.
• Children aged 17-years or younger.
• Patients requiring compression therapy or a Doppler investigation (Ankle-Brachial Pressure Index or Toe Brachial Index) that do not have a wound.
• Wound associated with medical devices (i.e., PICC lines, AV fistula, nephrostomy sites including bag changes or flushes) and drains. (Pressure damage inadvertently caused by a medical device: e.g., pressure ulcer from sitting on device, should be referred to the DCHS Wound Clinic service as per 'In Scope' referral criteria).
  • Respiratory related devices (i.e., nasal canula, BiPap, CPAP masks) refer to Respiratory Team/Service as per local arrangements.
  • Urinary related devices refer to Continence Service as per local arrangements.
  • Drains are used post-operatively and these wounds usually heal in under 4-6 weeks therefore these should stay with the GP (Note to referrer: Any complications relating to a drain during this timeframe should be referred back to the surgical team for review).
• Acute or traumatic wound on immediate presentation or likely to heal in 4-6 weeks (i.e., dog bite, abrasion, puncture, skin tear, burn)(Note to referrer: Consider referring skin tears and burns to A&E if extensive or significant tissue loss).
• Foot or toe wound below the level of the ankle (malleolus) that does not require lower limb compression bandaging or is managed in compression garments (i.e., hosiery or wraps) that can be applied by patient/family/carer. This includes ingrown toe nails and nail pathologies. These foot and toe wounds should be referred to the DCHS Community Podiatry Service.
• Simple Wound (Non-Surgical)
  • Wound that is likely to heal in 4-6 weeks with standard dressings. If a wound is likely to heal at week 5 or 6 this should stay with the GP.
  • Wound requiring suture removal only.
  • Dressing checks.
• Simple Wound (Surgical)
  • Wound that is likely to heal in 4-6 weeks with standard dressings. If a wound is likely to heal at week 5 or 6 this should stay with the GP.
  • Wound requiring suture removal only.
  • Cavity wound that requires packing that is less than 5cm deep or tunnelling or undermining less than 2cm and do not meet any of the 'In Scope' referral criteria (Note to referrer: Consider supported patient self-care and non-daily dressing options for these patients; seek DCHS Tissue Viability Support if required).
  • Dressing checks.
  • Any surgical wound with active drain.

Patients with active diabetic foot disease (ulceration, Charcot Neuroarthropathy (red, hot, swollen foot), infection) should be referred to the local multidisciplinary Diabetic Foot Team at identification according to local arrangements in line with NICE Guidance.