Referral Support for Venous Disease

Referral Support for Venous Disease is a service designed to help GP colleagues refer patients who may have venous insufficiency, varicose veins, skin changes, or ulceration. We do not typically require a referral, and patients can book appointments directly with our clinics.

If a referral is required or requested by the patient, this page provides clear information on referral criteria, assessment pathways, and how to contact our team directly. GP colleagues can refer directly by contacting our secretary on 01793 646263 for advice on referral pathways and access to specialist venous assessment services.

About the service

Our consultant-led clinic provides assessment and management of venous disease for patients across Swindon, Wiltshire, Gloucestershire, and Oxfordshire. All patients are reviewed by a Consultant Vascular and Endovascular Surgeon, with a full clinical examination and a duplex ultrasound scan performed at the same appointment.

When to refer

Referral is appropriate for patients with:

• Symptomatic varicose veins (physiological or psychological symptoms are both accepted)


• Chronic venous insufficiency with skin changes


• Recurrent superficial thrombophlebitis


• Venous leg ulcers or slow-healing wounds


• Suspected venous reflux requiring duplex ultrasound

Services provided

Consultant-led clinical assessment

All patients are assessed in person by a Consultant Vascular and Endovascular Surgeon. Assessment includes a focused venous history, clinical examination, and correlation of symptoms with objective findings. Particular attention is paid to disease severity, skin changes (including correlation with CEAP classification), ulcer history, and previous venous interventions.

Duplex ultrasound assessment

Comprehensive duplex ultrasound of the superficial and deep venous systems is performed at the same visit. This includes assessment for venous reflux, obstruction, and anatomical variation. Findings are used to confirm diagnosis, guide management decisions, and support referral documentation.

Varicose veins and venous reflux

Assessment of symptomatic varicose veins, including truncal and non-truncal reflux, recurrent varicose veins, and complications such as superficial thrombophlebitis. Management options are discussed in line with current NICE guidance and individual patient factors.

Chronic venous insufficiency

Evaluation of patients with chronic venous disease, including venous eczema, lipodermatosclerosis, oedema, and skin pigmentation. Duplex findings are correlated with clinical presentation to determine disease stage and appropriate management pathways.

Venous leg ulcers

Assessment of active or healed venous leg ulcers, including identification of underlying venous reflux or obstruction. Duplex mapping is used to support ulcer management, healing strategies, and recurrence prevention. Patients with mixed aetiology are identified appropriately.

Doppler pressure measurement and compression guidance

Where clinically indicated, hand-held Doppler assessment of ankle and, where appropriate, toe pressures is performed to support safe prescription of compression hosiery or bandaging. This is consistent with UK guidance recommending assessment of arterial perfusion prior to compression therapy.

Compression limitations and mixed arterial–venous disease

Patients with suspected or confirmed mixed arterial and venous disease are identified during assessment. Where arterial insufficiency is present, standard compression may be inappropriate or require modification. Clear documentation is provided to support ongoing multidisciplinary management.

Minimally invasive venous treatments

Where appropriate, patients may be considered for minimally invasive venous interventions, including endovenous thermal ablation and ultrasound-guided foam sclerotherapy. Treatment decisions are based on clinical findings, duplex results, and patient suitability.

Post-assessment communication

Following assessment, a clear written summary is provided outlining clinical findings, duplex results, and recommended management. This supports continuity of care and informed decision-making for referring clinicians.

How to refer

GP colleagues can refer patients by contacting our secretary directly on 01793 646263. If you prefer to send a referral via a hospital email address, please call the same number and the appropriate details will be provided.