References

Covid-19: England had highest excess death levels in Europe by end of May. 2020. https://tinyurl.com/y6ppfbge (accessed 3 August 2020)

Where are we now?

13 August 2020
Volume 29 · Issue 15

‘We are where we are’ said the local newsagent. This left me thinking, where are we? What have we learnt? And how has the last year influenced our tissue viability (TV) care? I have spoken to many TV specialists who have had a varied response from management as to how they continue to provide a TV service. This varies from continuing in their current provision to a complete disbandment of the service. Many continued with a lesser service and also took on additional roles, including significant leadership roles or supporting a whole trust with the fitting of personal protective equipment (PPE).

For some it will have been a time of opportunity, with many achieving more support for self-care, the use of telehealth and e-assessing and e-reviewing of patients. Many people have commented how the pandemic has dragged the NHS into the modern era of digital technology and what it can offer health care. The crucial thing is for the NHS to really benefit from this technology in the future—it could significantly increase the number of patients receiving TV advice and expertise. From my personal experience the travelling time taken to visit one patient could have been more beneficially used with telehealth. The challenges I faced from management, clinical governance and IT in implementing telehealth would now be easier to overcome. Another change has been the greater focus on self-care. This needs to be appropriate and well delivered, with innovative products in some instances, but community TV staff have said they can see greater opportunities for this.

It was announced at the end of July that the UK has the worst rates of excess deaths in Europe (Duncan et al, 2020) and as with all data you need to consider the factors that have influenced this. You must make your own decision whether you think health and social care have had a disjointed approach and whether we have taken care of the most vulnerable. Certainly there are questions about care and delivery and the pandemic has highlighted the need for care for all in a consistent way. Boris Johnson has said that the government did not understand coronavirus for months, which exemplifies the complexity of understanding any health issue. I think there have been some small revolutions that can be harnessed for the good of general health that would impact on TV care.

These include:

  • Increased awareness of the need to fully understand the complexity of a health issue and the need for an appropriately funded strategy
  • The importance of communicating a message clearly, based on evidence that is open to external scrutiny
  • The importance of moving at scale and pace—how quickly were the Nightingale hospitals built?
  • Increased awareness of general health among the general population
  • Increased awareness of infection prevention and control, particularly hand washing and personal hygiene and social distancing
  • Increased awareness of the value of maintaining a healthy weight and the value of regular exercise
  • The importance of mental health and wellness
  • Greater appreciation of the role of NHS and social care staff
  • The importance of well informed and appropriately delivered self–care.
  • Although not all the small revolutions brought about by the pandemic should endure, there are some that should. A greater focus is needed on health, appropriate funding for health, equity within health and social care, and the importance of implementing and fully supporting strategic plans. This is also the case in relation to the National Wound Care Strategy. Wherever they can, individuals taking responsibility for care and the focus on gathering meaningful consistent data that measures outcomes will be a significant start.

    Unfortunately the WCAUK has had to cancel both conferences this year and I can honestly say we have really missed seeing you at our conferences. As we look forward to next year we have two skills days planned. The first is in Exeter on 15 April 2021—bookings are now being taken—with the second at Cheltenham racecourse on 21 October 2021. I look forward to seeing many of you next year.