The summer has seen changes … a change of government, a change of health secretary and a change in policies. The proposed salary increases for healthcare staff, which at the time of writing are still subject to approval, would see the Pay Review Body recommendation for nurses and allied health professionals for 2024 fully implemented. There is finally a positive move in the junior doctors’ pay discussions. Whether the respective groups accept the pay rises has yet to be seen. However, this does appear to be positive and will be important in the drive for more efficiency.
Many of you will be aware of the National Wound Care Strategy Programme's (NWCSP) work on the implementation of the leg ulcer and foot ulcer recommendations, which tested the assumptions of the business case (NWCSP, 2024a). The NWCSP (2021) has highlighted that in 2019, there were around 739000 leg ulcers in England, with estimated healthcare costs of £3.1billion per annum. It also highlighted that the growth in prevalence was predicted to be 4% per annum. A strategy was needed to both improve care quality and reduce costs.
Seven initial pilot sites of different sizes and structures provided NHS care and the evaluation demonstrated significant improvements in patient outcomes and, crucially, establishes a national benchmark for best practices.
Key findings include (NWCSP, 2024a):
- 52% of leg ulcers healed at 0–12 weeks, with an overall healing rate of 84% at 52 weeks for all lower limb wounds
- A 14% recurrence rate for leg ulceration, which is significantly lower than the implementation case assumption
- A 27.6 benefit-cost ratio based on outcomes achieved, suggesting a strong economic case for adoption of a dedicated lower limb wound care service
- Estimated net zero impact from patients receiving optimal care: 473305kg of CO2 emissions, equivalent to 277 cars driven in a year.
Take time to read the executive summary. It contains some interesting reading and demonstrates improved clinical and financial efficiencies.
The NWCSP has also recently released a webinar on surgical wound complications (NWCSP, 2024b).
Although there are improvements to be made in all aspects of healthcare, including tissue viability, there is innovation and change in many areas.
A development in sepsis research could cut the time it takes to analyse cases where sepsis is caused by bacteria and to identify an effective antibiotic from more than 48 hours to about 12 hours (Blakely, 2024). Around 48000 people die from sepsis-related illnesses annually (Blakely, 2024; UK Sepsis Trust, 2024).
An area of concern is the £2.87billion paid out by the NHS in damages and legal costs for the alleged mistakes of medical professionals over the past year (Ames, 2024). However, a record 81% of claims in England were resolved in 2023/24 without resorting to legal proceedings (NHS Resolution, 2024).
There are areas of tissue viability and wound care that require improved efficiencies so we need to be well informed and to think of innovative new approaches. I was heartened by meeting a group of students undertaking a wound healing and tissue repair module at Birmingham City University (www.bcu.ac.uk/wound-healing-msc). As a result they are implementing changes in their own areas of work, including in patient engagement and lower leg care.
Let us hope the changes remains positive, the NHS needs it. On another note, I hope you get a change of scene this summer, with some time away to recharge as we prepare for a busy autumn ahead.