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Space to reflect on leg ulcer lessons

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In April the southern Leg Ulcer Forum conference adopted the theme of sharing practice. This was one of a series of LUF events and this particular programme will run again in Durham on 12 September.

The programme was a mixture of pathophysiology, clinical case studies, practice skills and workshops aimed at creating business plans, winning funding for projects and creative thinking about practice challenges.

Delegates pooled resources to answer questions about how leg ulcers develop and it was great to see less experienced and very specialist practitioners getting stuck in with debate. In the clinical case studies, specialist nurses presented very complex patient case studies and invited delegates to share experience and comment on decisions made.

The business planning session considered the context of strategies arising from the Darzi report High-Quality Care for All, and how this is driving service developments and collaborative working in health services, industry and universities.

In the creative thinking workshop there was discussion of what made a good leg ulcer service and how we learn and apply lessons - and about experiences we would rather not have had over the years.

The funding session highlighted sources of support for projects and particularly how many manufacturing companies invest in education and development of skills and services within healthcare teams and for individuals. There is sometimes scepticism about this and it is right to maintain a certain caution but also a need to explore avenues that can bring benefits to patients.

Each year there are various award ceremonies to celebrate innovative practice; many of my own students and colleagues have had glittering nights at such ceremonies and more importantly publicity for work they have done for patients. I think we are getting better at sharing good practice but I don’t think we are universally good about encouraging colleagues to extend their skills and put themselves forward for those glittering prizes.

For me, the key reflection points at the LUF conference were that we need to take a triangular approach to services:

  • Learning from case studies of the complexities in practice;
  • Developing skills in assessment and compression therapies so that patients have an equitable service;
  • Developing business skills to ensure that services are driven by practitioners who are skilled, knowledgeable and supported to build an effective and sustainable service.

Publicity about the impact of such services on outcomes for patients will be a major driver for change. If there is any hope of this, practitioners need to be willing to learn from each other and facilitate skills in others to ensure a continuous stream of knowledgeable and motivated people committed to patient care.

Irene Anderson is programme tutor, tissue viability, University of Hertfordshire.

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