Comment

Introducing The Leg Club to curb high demand of leg ulcer appointments

After trialling a Leg Club set up by Ellie Lindsay, the Adam Practice in Dorset found they could benefit from the services and help reduce patient demand for leg ulcer appointments, and social isolation.

Like many practices, The Adam Practice treatment rooms were full and had high demand for leg ulcer appointments.

The practice consists of four surgeries and 32,500 patients. An internal practice audit demonstrated that more than 50% of appointments were for lower leg care, and a significant proportion of patients presenting with long term or recurrent ulcers.

Reviewing this, I felt there was a need to consider how we delivered care. Following investigations into different models of care and persuading a colleague to visit a Lindsay Leg Club in another county with me, we concluded that this was the best model to help us engage and empower our patients.

Funding

After presenting my findings to

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Like many practices, The Adam Practice treatment rooms were full and had high demand for leg ulcer appointments.


Following the Leg Club introduction in Dorset, a practice has seen better healing rates
and less recurrence of lower limb conditions in patients. Picture: Chris Balcombe

The practice consists of four surgeries and 32,500 patients. An internal practice audit demonstrated that more than 50% of appointments were for lower leg care, and a significant proportion of patients presenting with long term or recurrent ulcers. 

Reviewing this, I felt there was a need to consider how we delivered care. Following investigations into different models of care and persuading a colleague to visit a Lindsay Leg Club in another county with me, we concluded that this was the best model to help us engage and empower our patients.

Funding

After presenting my findings to our GP partners and the CCG locality, funds were secured to support the setup of the first Leg Club in Dorset. The Best Foot Forward (BFF) Leg Club is based on the award-winning healthcare model founded by former district nurse Ellie Lindsay, where nursing staff and volunteers work in conjunction to provide holistic care to patients who have lower limb conditions.

We decided, in agreement with local community teams, that many patients being treated at home could, with transport, be treated in a Leg Club environment, and this would help to reduce their social isolation. An essential objective in the early stages was to liaise closely with our patients and the local community, to engage and ensure we were meeting their needs.

The BFF opens one morning a week and anyone from our practice sites can attend, for either treatment or maintenance, to encourage self-care.

Future aspirations

BFF Leg Club has been open for 24 months and due to its success, it has relocated to larger premises. This enabled exploration of future working with other disciplines to support our members’ health. Our members have achieved better healing rates and recurrence of lower limb conditions through patient centred care, empowerment and shared care.

'Crucially, BFF Leg Club helps to relieve the social isolation that is frequently experienced by patients with leg ulcers'

We work as an integrated team with the community team and an amazing team of volunteers provide the valuable social aspect. There has been a clear demonstration of improved well-being and self-esteem through social interaction and meeting new friends. There has even been some rekindled friendships from many years ago.

Five Year Forward plan

We are fully supported by the Lindsay Leg Club Foundation who provide education, guidance, audit of healing and monitoring of infections. This model of care sits with the health and well-being agenda of the NHS England Five Year Forward plan and links to local sustainability and transformation plans.

This experience has been an interesting journey and I hope will inspire others to seek to improve care by questioning current working practices and stimulate patient empowerment. Being a change agent can be challenging, but simultaneously rewarding. I believe the key to success was involving staff and patients early in the planning stages and engaging those that are initially resistant, giving equal consideration for practice and community trust policies and procedures.


About the author

Clare Mechen is a Queens Nurse, an advanced nurse practitioner and clinical nurse manager for The Adam Practice in Dorset, and was also a finalist in the Community nursing award at the RCNi Nurse Awards 2017.

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