Norma

Burden of wounds in the United Kingdom1

  • 3.8 million patients with a wound are managed by the NHS annually.
  • 25% of all wounds lacked a recorded differential diagnosis.
  • Annual cost of managing these wounds is £8.3 Billion, of which 67% was spent on managing unhealed wounds.
  • Over 70% of the cost is associated with Nurse, Doctor, or HealthCare Assistant visits.
  • 81% of the total cost was incurred in the community. Between 2012 and 2017, there was an estimated 30% decline in the number of district nurses employed in front-line patient care.

 

  1. Guest JF, Fuller GW, Vowden P. Cohort study evaluating the burden of wounds to the UK's National Health Service in 2017/18: update from 2012/13. BMJ Open 2020:10:e045253. doi:10.1136/bmjopen-2020-045253 2. Gray TA, Rhodes S, Atkinson RA, et al. Opportunities for better value wound care: a multiservice, cross-sectional survey of complex wounds and their care in a UK community population. BMJ Open 2018;8:e019440. doi:10.1136/bmjopen-2017-019440 3. NHS operational productivity: unwarranted variations. Mental health services and Community health services. May 2018  *Anthropological study 2019, Coloplast
The impact of a optimal vs sub optimal patient pathway<sup>3</sup>

The impact of a optimal vs sub optimal patient pathway3

Using a fictional patient Betty, NHS Right Care examined a leg ulcer pathway, comparing a sub-optimal but typical scenario against an ideal pathway.
 
This scenario demonstrated opportunities to reduce the unwarranted variation, positively impact Betty's quality of life and reduce costs. 
 
Sub-optimal pathway - Wound healed in 2 years:  £5673
Optimal pathway - Wound healed in 6 weeks:        £505
 
3. NHS Right Care, 2017. NHS Rightcare Scenario: The variation between sub-optimal and optimal pathways: Betty's story Leg ulcer wound care.
 
Unwarranted variation

Unwarranted variation

Unwarranted variation can occur in different ways: between geographical areas, specialties, population groups and access to products and services. In order to address unwarranted variation, it needs to be identified and changed.  
 
A review of productivity and efficiency by Lord Carter into community health services concluded that there is critical and unwarranted variations across all the main resource areas2. Wound care was highlighted as a structural issue in the provision of services delivered in the community, that was recognised but not adequately dealt with2.
 
Community health services can play a more significant role in improvements in the wound care pathway for patients, where the Getting It Right First Time (GIRFT) programme can help to reduce unwarranted variation2. 
 
2. NHS operational productivity: unwarranted variations. Mental health services and Community health services. May 2018