Where does the real problem lie?

Abstract

Journal of Wound CareVol. 27, No. 6 EditorialFree AccessWhere does the real problem lie?Rachel WebbRachel WebbSearch for more papers by this authorRachel WebbPublished Online:8 Jun 2018https://doi.org/10.12968/jowc.2018.27.6.353AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail At the end of May I was invited to attend a meeting at the House of Lords (HoL, London, UK) to discuss a National Wound Care Strategy. The event was attended by 50 people with differing interest in the project, including NHS improvement, tissue viability nurses, podiatrists, surgeons, industry, wound care societies and charity representatives and academics. Quite a mixture of people. The meeting was hosted by the Rt Hon. Lord Hunt of Kings Heath and started with a talk from Prof Julian Guest on the burden of wounds,1 who was followed by Margaret Kitching (Chief Nurse North) who gave a overview of how a national wound care strategy was to be created. A summary of the key points made can be found on page 403. However, on reflection I wanted to talk about something that was perhaps not given the significance it deserves.It the meeting it was said that 74% of wounds were managed by district nurses, however, the number of district nurses in England has halved since 2010.2 So most wound are managed by district nurses and the number of district nurses in England has fallen. Neither of these points was given much time at the meeting—although Baroness Watkins did state that 5000 more district nurses would be recruited by 2019. I don't have a full list of participants at the meeting, however I do not believe there were any district, practice and general nurses in attendance, and if so, they didn't offer any comments from their perspectives. It was also unclear as to whether these groups, and in particular district nurses, would be represented on/at any of the boards/workshops/work stream groups which will create a National Wound Care Strategy.Given this, here is my point. The people who manage most wounds should be key to the strategy. It is from those who deal with the most wounds that we can learn why we are failing patients, and what is required to facilitate wound healing. Is it as simple as more resources and better education? Furthermore, as best practice and National Institute for Health and Care Excellence (NICE) guidelines already exist, but are not always adopted, are new pathways created by another set of experts really required, or should we examine what the hurdles are to using the current guidelines. Lack of time/money/education? Before we reinvent a wheel that seems to have been invented many times before, maybe we should look and see why it's not being used in its current form, and while having panels of wound care experts will provide the best and most up-to-date evidence and practice available, this may not be where the problem lies. If the most basic information on wound care is not getting to those who deal with the majority of the wounds whatever else we choose to do may end up being a little pointless.Don't misunderstand me. I think creating a national strategy in England is hugely exciting, important and a great step forward for wound care—or woundology, as one panel member suggested—especially given the predicted increase in the problem. However, this must include input from those who see the majority of wounds so we can clear identify the problems and undertake the appropriate initiatives. References 1 Guest JF, Ayoub N, McIlwraith T et al.. Health economic burden that wounds impose on the National Health Service in the UK. BMJ Open 2015; 5(12):e009283. doi: https://doi.org/10.1136/bmjopen-2015-009283 Crossref, Medline, Google Scholar2 Hughes D. District nurse numbers under pressure. BBC http://www.bbc.co.uk/news/health-41974736. 20 Nov 2017 (accessed 31 May 2018) Google Scholar FiguresReferencesRelatedDetails 2 June 2018Volume 27Issue 6ISSN (print): 0969-0700ISSN (online): 2052-2916 Metrics History Published online 8 June 2018 Published in print 2 June 2018 Information© MA Healthcare LimitedPDF download