Clinical update

Wound care: what the framework for standardised treatment means for your patients

Guidance focuses on individualised care for pressure ulcers, lower limbs and surgical wounds

Guidance focuses on individualised care for pressure ulcers, lower limbs and surgical wounds

Wounds on lower limbs can require treatment for weeks, if not months Picture: Alamy

Essential facts

An estimated 3.8 million people in the UK are living with a wound, according to research quoted by the National Wound Care Strategy Programme.

The annual cost of wound management is thought to be £8.3 billion in England alone. This includes 54.4 million district or community nurse visits, 53.6 million healthcare assistant visits and 28.1 million practice nurse visits.

Many people experience long-term pain, discomfort and poor quality of life as a result of living with their wound, the programme says.

Wide variation in services, the underuse of evidence-based practice and an overuse of ineffective interventions can lead to poor healing rates, increasing the demand on scarce resources, it says.

What’s new

In June 2021, the programme launched a new England-wide multiprofessional framework, with the overall aim of standardising wound care across all health and care roles and settings.

It focuses on three clinical areas: pressure ulcers, lower limbs and surgical wounds.

The National Wound Care Core Capabilities Framework is designed to be a single, consistent and comprehensive foundation underpinning the highest standards of wound care.

‘Non-healing or delayed healing of chronic wounds is a major factor in care costs and many of these wounds could be prevented or healed more quickly,’ says Skills for Health, which developed the framework with Health Education England.

Created by a multiprofessional team, it sets out the knowledge, skills and behaviours needed by staff at every level of the health and social care workforce.

Core capabilities are divided into three tiers, with practitioners in health or care settings moving up the tiers as appropriate for their role, setting or circumstances:

  • Tier 1 outlines general knowledge and understanding of wound care and the skills supporting its provision.
  • Tier 2 includes the capabilities to enable independent wound care provision, with a degree of critical analysis.
  • Tier 3 focuses on capabilities requiring a high degree of autonomy and complex decision-making, including leading wound care practice and enabling innovative solutions to enhance people’s experience and improve outcomes.

How you can help your patient

Holistic assessment of the person with a wound and a personalised approach to their care underpin the framework.

‘People with wounds should be engaged in shared decision-making about their care and supported to actively make the decision about their preferred care and treatment plan,’ the framework says.

In practice, health and care practitioners should take account of the preferences, priorities and needs of individuals with wounds to support and guide their care and treatment.

Practitioners and their employers should also determine which tier of knowledge and skills aligns with their specific role. The framework encourages education and training focused on developing core capabilities, optimising opportunities for interprofessional learning.

Expert comment

Crystal Oldman, chief executive, Queen's Nursing Institute

Nurses have been experts in wound care for decades and this framework recognises their expertise.

Standardising wound care with this kind of evidence-based documentation to support nurses in their work can only drive up the quality of care. It provides nurses with the confidence that the care they are providing is based on evidence.

Living with a wound can be hugely compromising for someone’s life. Wounds may heal as they should, within the timeframe and without infection, or they may be long-term, especially wounds on lower limbs, and require treatment for weeks, if not months.

This framework highlights what nurses can do to improve someone’s quality of life by accelerating their wound healing, reducing the possibility of infection.

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