The Commissioning View - Setting the Strategy for Reductions in Prevalence of Pressure Sores

Abstract

The Department of Health's Priorities and Planning Guidance for 1994/95, which is the means by which the Department sets objectives for the NHS as a whole, required that district health authorities should ensure that ‘contracts specify that providers should record prevalence of pressure sores, differentiating between those acquired in hospital and others, and are encouraged to set annual targets for an overall reduction of at least 5% working from a baseline of 1993-94 figures.’1 Within a Regional context, the RHA established this target within its Corporate Contract with each DHA. This paper looks at the follow-up processes which are being applied to ensure that purchasers (health authorities) are able to meaningfully apply the target set out in the guidance. A review of progress of purchasers was carried out in Spring 1994 - this showed a tendency by purchasers to pass on the target in a mechanistic fashion ie contracts with providers contained the target, but there was little discussion about means and methods. Phase two of the project involved a survey of providers to identify good practice. The third phase, which is just beginning involves the formation of an interest group to develop a checklist for purchasers. In the final phase of the project the Checklist will be disseminated to purchasers to be implemented locally. Through this approach a “top-down” target will be translated into the context of existing work taking place in provider units, which will then be used to inform guidance for purchasers to steer district-wide initiatives to improve pressure sore management and achieve reduction in prevalence and incidence of pressure sores.