Why the NHS needs to radically rethink chronic wound care

Nurses know the toll that chronic wounds exert from patients. The pain. The emotional and physical distress.¹ The smell, which can cause embarrassment, disturbed sleep, anxiety, depression and low self-esteem.^{2, 3} The exudate that leaks onto furniture, bedding and clothes.² The social isolation. The reduced mobility, partly because of the all-too-frequent amputations.¹ Not surprisingly, chronic wounds often leave patients’ partners and families experiencing ‘severe emotional and physical trauma’.¹

Wounds also exert heavy financial and clinical tolls. In 2012/2013, the NHS managed an estimated 2.2 million patients with wounds, equivalent to about 4.5% of adults. Managing these wounds and the associated co-morbidities involved 18.6 million practice nurse visits, 10.9 million community nurse visits, 7.7 million GP visits and 3.4 million hospital outpatient visits, which cost the NHS £5.3 billion. The economic burden imposed by wounds on the NHS is ‘comparable to that of managing obesity’.⁴ Yet chronic wounds capture a fraction of the attention paid to obesity.