NHS: Wound Care

Lord Colwyn Excerpts

Wednesday 22nd November 2017 Lords Chamber

[Lord Colwyn (Con)]

My Lords, I congratulate the noble Baroness, Lady Wheeler, on her explanation of the follow-up questions asked by the noble Lord, Lord Hunt, on the development of a strategy for standards of wound care in the NHS. If noble Lords will permit, I shall establish the context in which wound care sits within the pressures faced by health services. I do not have any financial interests to declare.

It is no exaggeration to say that improving wound care in the NHS is a crucial part of tackling one of the greatest health and economic challenges of our age: antimicrobial resistance. AMR is causing a rise in drug-resistant infections, killing some 700,000 people worldwide. In the UK alone, it results in 3,000 deaths a year, with an estimated cost to the NHS in excess of £180 million a year. Without global action, according to the 2016 report of my noble friend Lord O’Neill on this issue, AMR will kill another 10 million people annually by 2050. According to my noble friend’s findings, the increase in death and illnesses is set to wipe approximately $8 trillion off the world’s annual output by 2050. Discussing how we can improve wound care is vital to addressing the challenge of AMR.

Some of the most challenging wounds are skin and soft-tissue infections. These include infections of skin, tissue, fascia and muscle. SSTIs are the second most common infection in hospitals. They often involve the invasion of deeper tissues and typically require significant surgical intervention. Between 7% and 10% of hospitalised patients are affected by SSTIs and such infections are very common in the emergency care setting. For complicated SSTIs, the response to therapy is often complicated by underlying disease states, such as infected burn wounds and deep-space wound infections. These infections are often limb or life-threatening.

A significant body of research on SSTIs has been conducted by Dr Matthew Dryden, clinical director of infection at Hampshire Hospitals NHS Foundation Trust and at Public Health England. Dr Dryden has highlighted that SSTIs are some of the most common infections, suffered by everyone at some point in their lives and encountered by all doctors. However, it is clear that if we are to improve the way the NHS addresses wound infections and halt the rise of antimicrobial resistance, new treatments are needed. Thankfully, along with colleagues at the Universities of Manchester, Birmingham and Southampton, Dr Dryden has been working to develop an extremely promising new treatment based on reactive oxygen technology.

At this point I have a personal interest to declare, as my younger brother suffered wounds infected with MRSA, C. difficile and pseudomonas. Despite hospitalisation and intravenous antibiotic treatment over three years, the bacteria were antibiotic-resistant and, after he eventually developed sepsis, to save his life his leg was amputated. Following this, a further wound developed, showing pseudomonas. Having read about the success experienced with reactive oxygen and the work carried out by Claire Stephens and her charity Woundcare4Heroes, I was able to introduce them to my brother’s clinical team. His wound has since been successfully treated with reactive oxygen and I am pleased to say that the bacteria have cleared and the wound is now fully healed—although he is still minus one leg.

The research and development of reactive oxygen is being led by a British biotechnology SME, Matoke Holdings, which is committed to meeting the challenge of antimicrobial resistance. In my career as a dentist, I was aware of some of the important work being done using oxygen in oral healthcare, about which I have spoken in previous debates. I am excited that oxygen is now at the forefront of work to address wound care and AMR, with the development of reactive oxygen.

Reactive oxygen is a British-led innovation that represents a new generation in antimicrobials and offers a breakthrough in medical research. In both laboratory and clinical tests, reactive oxygen has been proven an effective treatment of Gram-positive, Gram-negative, multi-resistant and pan-resistant bacteria. Indeed, research has demonstrated that it can kill many of the priority superbugs highlighted by the World Health Organization.

The first product based on this technology, a medical device, is already approved by the EU regulatory body and being prescribed through the NHS. Such technology has huge potential to save lives and deliver significant savings to the NHS by providing an effective new treatment for chronic wounds. This can reduce the number of amputations and days spent in hospital with nursing care. Scientific research suggests that the technology has a far wider potential, including as a stimulant of tissue regeneration and in the treatment of urinary tract infections and respiratory infections.

I am aware that Matoke is going through the pharmaceutical regulatory approval process, involving clinical trials, to address infected human soft tissue. Such innovative British technology, which represents a new generation in antibiotics, needs to be brought to the forefront of the policy discussion about wound care, both within the UK and globally. However, the cost and timescales involved in research and development are a hindrance to bringing new treatments into the NHS. Given the scale of the AMR threat, public bodies need to do more to identify the most promising potential solutions and help push these forward.

I welcome the announcement of the new accelerated access pathway, chaired by Sir Andrew Witty, which I hope will accelerate the development of reactive oxygen and bring transformative treatments to patients in the NHS as a priority. I hope that Sir Andrew will consider reactive oxygen as a candidate for the pathway. If the Government are to deliver on their bold commitment to meet the global AMR threat, they also need to include specific support for SMEs involved in the development of new antimicrobials in their response to Sir Hugh Taylor’s life sciences strategy.

Britain is a world leader in scientific research. Improving the standard of wound care in the NHS will require us to improve how we translate this research into new wound care treatments in the NHS. I believe that reactive oxygen offers one of the most exciting prospects for achieving this. I would be grateful if the Minister would meet Matoke Holdings so that he can hear first-hand the challenges faced by SMEs working on the front line to make new wound care treatments available to the NHS.