Article

Addressing the urgency in wound care: alleviating the unseen suffering in patients

21st February 2024 > 5-minute read

 

 Jacqui Hughes

Measuring health outcomes is of paramount importance for the NHS, playing a pivotal role in enhancing the quality, efficiency, and effectiveness of healthcare delivery. The NHS faces the dual challenge of providing equitable access to healthcare services while ensuring that the care delivered leads to positive health outcomes for individuals and the wider population.1

Within an array of specialities and departments, patients who suffer with a wound often go unnoticed. Wounds are present disproportionately in patients with comorbidities and those who are 65 years and over.2 The suffering and reduced quality of life for these patients can be devastating. A national data set of 11,524 wounds collected from 2016 to 2023 gives a flavour of the extent of the problem and a realisation that the situation is not getting any better.


Of the 11,524 wound data collected3:

• 2133 (18.9%) were more than a year in duration.

• 2773 (24.6%) were between 3 months and a year in duration.

• 3084 (27.4%) wounds were considered static.

• 873 (7.7%) wounds were deteriorating.

• 1731(15.9%) had one hospital admission; 1000 (9.1%) had 2 or more hospital admissions due to the wound.

 

Clearly, this area of healthcare demands immediate attention4 as the wound population is one that sees an approximate annual spend of £8.3 billion with prevalence increasing by 71% over a 5-year period2.

At a time when the NHS is facing multiple challenges as a resource constrained system, the idea of change can be overwhelming. However, change when managed correctly can optimise workflow, reduce waiting times, and enhance overall efficiency across a system. These effectual benefits can be applied to wound care as much as any other area of healthcare.

Wound care is an area of health care that has recently gained recognition from government with the formation of the National Wound Care Strategy Programme. There is greater understanding in terms of both the cost associated with treating this cohort of patients, but also with the overwhelming staff resource needed as a result. A lack of focused local data, however, means that the burden to individual Integrated Care Boards and subsequent urgency of the situation is often overlooked. As a result, appetite for continuous improvement strategies in this area remains low. Given that change management is often perceived as difficult, easy to use and understand programmes are required to facilitate the process. Continuous improvement initiatives that support service redesign are fundamental to mitigate the increasing problem that the UK is now facing in terms of the overall wound care population.

The COMPASS Programme is an easy to implement value-based step by step change management process that utilises Smith+Nephew’s expertise which aims to help health systems to reduce cost, improve outcomes, free up clinical time and improve the quality of care for patients. The process is cyclic in nature and provides clear, personalised insights on the wound care service supported by the latest, award winning digital would care technology.

The programme consists of 4 simple steps:

Orientate - reviews current practice using data insights to establish a starting point.

Navigate - identifying and agreeing the desired plan (clinical practice change) and goals.

Activate - implementation of the agreed clinical practice changes with tools, solutions, and support.

Evaluate - review of the outcomes and impact based on data analysis pre and post intervention. Further improvements that can be made are translated into a new plan and revised goals. 

COMPASS 4 Stages Image.png

Wound care is at a crossroads in the UK. What we do now, and the decisions we make will impact heavily on the outcomes of patients who are presently suffering with a wound and those who might do so in the future. Failure to act given the extra conditions patients often face e.g., health inequalities with increasing levels of deprivation means that this cohort of patients could continue to slip through the net. Raising the profile of this issue requires a strategic, multifaceted approach utilising evidence-based methodology, alongside investment that is proportionate to the scale of the problem.

This report was written by Jacqui Hughes, Senior Health Outcomes Manager, Smith+Nephew

 

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Citations
  1. NHS Confederation. Transforming lives, improving health outcomes. Tackling the true variation in uptake of innovative medicines. 2023. NHS Confederation and ABPI partnership
  2. Guest J.F., Fuller G.W. and Vowden P. Cohort study evaluating the burden of wounds to the UK’s National Health Service in 2017/2018: update from 2012/2013. 2020. BMJ Open;10:e045253
  3. Smith+Nephew. Wound Compass Practice Review Master data set on file. 2023
  4. Harding K.G. Chronic Wounds: a clinical problem requiring ownership and coordination. 2022. British Association of Dermatologists:187;133-134

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