A new report by Public Policy Projects (PPP) has urged the NHS to re-examine its wound care strategy, warning that the current approach is failing patients and creating a significant cost burden for the health service.
The report, Going further for wound healing, finds that wound care is currently delivered in a “disjointed” way, with many patients suffering from sub-optimal care. This is leading to prolonged wound healing, increased pain and immobility, and a greater burden on the workforce. It proposes a series of policy recommendations aimed at achieving the wide-scale adoption of evidence-based practices to ensure its availability for all patients.
The report notes that the annual cost of wound care to the NHS is expected to reach £10 billion in 2023/24, making it the third highest point of expenditure after cancer and diabetes. However, the report argues that this figure could be significantly reduced if the NHS adopted a more evidence-based approach to wound care.
While there are existing programmes working to transform wound care across the UK, they currently operate in silos. To get this work rolled out nationally, the report calls for support from the Department of Health and Social Care (DHSC) and NHS England to address the currently disjointed approach to wound care and ensure that integrated care boards (ICBs) work to place wound care among their strategic priorities.
Measures to do this include the establishment of wound care leads at PCN level to coordinate the wound care workforce and the proposal for the Nursing and Midwifery Council to investigate mandatory educational standards to ensure that wound care education is taking place in pre and post registrational nursing training programmes.
The report’s recommendations include:
- ICBs should commission dedicated lower limb wound care services as set out in NWCSP’s recommended clinical pathway, to ensure all patients across England receive evidence-based wound care.
- ICBs should ensure the MDT approach for diabetic foot ulcer care is implemented in alignment with NICE guidance, if it isn’t already. Podiatry services should be commissioned to allow non-diabetic patients with lower limb wounds access to the same MDT diabetic foot clinics.
- ICBs should ensure that self-care delivery models of treatment are available for patients and their carers. Accordingly, they should invest in self-management facilitators, or ensure that HCPs are trained in self-management, to promote adherence to this model.
The report also highlights the need for better data collection and analysis to track progress and identify areas where further improvement is needed.
Lord Philip Hunt, a former Health Minister, said: “This excellent report by PPP highlights huge inequalities throughout the country in the quality and range of wound care. It points the way to transforming wound care delivery to save the NHS time, money and improve patient outcomes.”
Dr Paul Chadwick, Clinical Director of the Royal College of Podiatry, said: “I have been delighted to be part of this work as it shines an important light on an issue that is affecting many people in the UK and has a devastating impact on sufferers.”
Dr Una Adderley, Director of the National Wound Care Strategy Programme (NWCSP), said: “To date, improving wound care has not seen the policy attention it urgently needs. This PPP policy report is very welcome in raising the profile of wound care and drawing attention to this neglected area of care.”
The report can be downloaded in full here.
