Wound care patients suffer as NHS forced to 'skimp' on dressings
A staggering 2 million patients are treated for wounds every year at a cost of £5bn, says Lord Hunt of Kings Heath.
Wound care, is a massive challenge to the NHS but lacks priority, investment and direction. My debate tomorrow tonight in the Lords is intended to press the Government on the need for urgent action
A staggering 2 million patients are treated for wounds every year at a cost of £5bn. This includes over 700,000 leg ulcers and 80,000 burns. Pressure sores also feature highly with estimates of an 11% increase overall each year.
Whilst, the majority of all wounds heal within a year, a huge resource has to be committed to managing unhealed wounds. The NHS response is very variable. Healing takes far too long; diagnosis is not good enough and inadequate commissioning of services by CCGs compounds the problem with undertrained staff and lack of suitable dressings and bandages. There’s also been a worrying drop in the number of district nurses.
70% of venous leg ulcers should heal within 12-16 weeks and 98% in 24 weeks. However, in reality healing rates at 6 months have been reported as low as 9% with infection rates as high as 58%. Patients suffer and the cost of non-healing wounds is substantially greater to the NHS.
This will only be turned round with a nationally agreed strategy to reduce variation and increase outcomes. Dedicated wound clinics in the community are needed alongside a coordinated treatment plan to achieve best outcomes for patients.
The NHS has also to invest in high quality bandages and dressings, in contrast to the current skimping. The problem is that with the NHS financially as hard pressed as it has ever been, there is huge pressure to reduce the costs of medical equipment and clinical supplies like dressings.
The result is that for procuring dressings and other forms of treatment, there is not enough emphasis on the cost of patient care and too much focus is on the unit cost of products.
Not only does this lead to poorer and more costly outcomes for patients, there are a number of other unwelcome side effects: products will be less innovative and effective; a reduced amount of educational support; there will be fewer appropriate treatments available, and will lead to job losses if there is less sourcing from high quality British suppliers and manufacturers.
With cost, as the primary driver, suppliers to the NHS will have a race to the bottom – compromising quality. Poor quality dressings simply cannot withstand the rigour required.
It’s also massively counter-productive. If you reduce the availability of clinically appropriate dressings, - only 10% of the cost - patients will suffer as wounds take longer to heal and an increased burden on the NHS will follow. The result is longer hospital stays, more re-admissions, compromised quality of life, and repeated visits to GPs and community services.
This problem can only worsen. The average number of adult wounds that every Clinical Commissioning Group is expected to manage is expected to rise from 11,200 in 2012/13 to 23,000 in 2019/20. So there is an urgent need to get a grip with a nationally driven strategy.
Lord Hunt of Kings Heath is a Labour peer in the House of Lords and is a member of Labour's health team
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