NHS: Wound Care

Baroness Masham of Ilton Excerpts

Wednesday 22nd November 2017 Lords Chamber

[Baroness Masham of Ilton (CB)]

My Lords, I thank the noble Lord, Lord Hunt of Kings Heath, for selecting this very important subject and the noble Baroness, Lady Wheeler, for leading the debate.

I must declare an interest. I have been a paraplegic, paralysed from the chest down with no feeling, since breaking my back in 1958. I know only too well how important it is to have a high standard of wound care in the NHS. I also have to confess that I have a pressure sore, which needs constant care. It developed after one of my helpers inserted a slide board with too much gusto when I was getting out of my car. This broke the skin in a very difficult to heal place. My skin can be problematical and some wound dressings can give allergic reactions. There should be a good choice of dressings, as different wounds need a variety of dressings and patients like me can react and heal in different ways.

Wound care should be raised up the agenda. We need an upgrade, but some interested parties fear that wound care might be downgraded. Billions of pounds are involved and this is a very serious matter. I ask the Minister: does that figure include the millions lost to the National Health Service because of litigation from bad care?

I also declare an interest as a patron of the Lindsay Leg Club Foundation, which is a charity concerned with the leg ulcers that affect about 700,000 people in the UK. The cost of leg ulcer treatment and management is around £1.94 billion. The ulcers are painful and debilitating, they consume a vast amount of district nurses’ time and they often lead to social isolation. The Lindsay Leg Club Foundation helps promote a social model of care which improves healing rates, decreases social isolation and enables healed legs to be maintained with a “well leg” regime of care.

Does the Minister agree that a key aspect of improving wound care and reducing infections within hospitals rests with good hand hygiene? The first step in improving hand hygiene to reduce hospital infections is to acknowledge that the current method of direct observation is inaccurate. The availability of modern technology means that NHS trusts can today seek more accurate methods to monitor and drive improvements in hand hygiene and hence to reduce the risk of infections.

The Surgical Dressings Manufacturers Association is concerned that likely changes to NHS procurement in wound care could compromise patient safety and increase NHS costs. A possible reduction in the availability of clinically appropriate dressings will cause suffering to patients, as wounds will take longer to heal and place an increased burden on the NHS. If hospitals and care homes do not use the most appropriate dressings, patients with pressure ulcers will have to stay in hospital longer and will have a poor patient experience and outcome. The same applies to patients living in the community, but there is the added problem of the shortage of district nurses.

I hope the Minister will give the House some assurances tonight that wound care will not be downgraded and that there will be a strategy that will include the NHS and public health and that the private sector can learn from it too. We need people to work in this field who understand the importance of good wound care and who have the necessary skills and dressings to look after civilian men, women and children, the Armed Forces and people in prison in the best way possible.