I remember the first time I met someone with leg ulcers. I had never seen anything like it and couldn’t believe that no one seemed to be taking the issue of wound care seriously.
That experience drove my interest in wound care but although I worked hard, the issue needed something much greater than I could achieve on my own or even within my network of tissue viability nurses. I couldn’t understand why something that took up so much of my time was getting so little attention. When I heard about the launch of the National Wound Care Strategy Programme (NWCSP) I had to find a way to get involved.
Wound care places a large burden on healthcare providers, patients and carers and as obesity, diabetes, cardiovascular disease and an ageing population all increase, so do the number of people with chronic wounds. Variation in care means that people are living with wounds for much longer than they should, and their care is costing the NHS much more than it should.
I know lots of nurses are trying to make changes on an individual level but are working within in a system which makes this difficult. Wound care needs to look at the underlying causes of skin breakdown and poor healing, not just treat the symptoms.
We need to work in a collaborative way with other professional groups to address the co-morbidities that are often the cause of non-healing. There is a danger that we get stuck in silos, both structural and medical, which makes change difficult.
Wound care has for many years been driven by nursing, which has not always had the power to make changes across the system. With the NHS Long Term Plan encouraging collaborative working, the continuing development of nursing as a profession, and the National Wound Care Strategy Programme, we have a great opportunity to tackle the issues that block good quality wound care.
The NWCSP is developing recommendations about how to improve:
- The patient journey to reduce variation, improve safety and optimise patient experience;
- The supply and distribution of products and services for wound care;
- Access to education for healthcare practitioners, patients and carers;
- How we gather and use of information so we can work more effectively.
Putting these recommendations into practice will be a challenge. Changing practice can feel like more work in an already busy world. We must turn that mindset around. Changing how we work will help us improve patients’ quality of life and save staff time.
We need to think about how we organise our services, so that patients are seen by nurses and other key professionals, who not only have the right skills and knowledge but the opportunity to maintain and develop that expertise.
“Service redesign is the key to success”
People often have knowledge about what needs to happen but the system stops them developing or maintaining the necessary skills or referring to the relevant services.
Ultimately, service redesign is the key to success, but we must consult with those who will be affected by these changes. We are doing this through the Stakeholder Council, chaired by Jo Gander, NHS Supply Chain’s director of clinical and product assurance.
The Council oversees three forums for health and care professionals, patients, carers, citizens and suppliers. I urge any nurses interested in improving wound care to join the Health and Care Professionals Forum.
Wound care is a fundamental part of nursing. Together, we can drive the improvements needed to make a real difference for patients with wounds.
Una Adderley is a Queen’s Nurse and director of the National Wound Care Strategy Programme