Improving care for patients with lower limb wounds

KSS AHSN is delighted to be one of an initial six AHSNs working to deliver the nationally important Transforming Wound Care (TWC) programme.


The challenge

Most lower limb wounds heal within a few weeks. However, many wounds below the knee fail to heal as normal – these are known as chronic lower limb wounds. Chronic lower limb wounds account for at least 42% of all wounds in the UK, with leg ulcers being the most common type.

Most of the total wound care spend is for these chronic lower limb wounds, because of their slower healing rates. In 2019, there were an estimated 739,000 leg ulcers in England with estimated associated healthcare costs of £3.1 billion per annum year.


The prevalence of total leg ulcers is expected to increase by around 4% annually, to over one million by 2036 if there is no intervention, according to evidence from the National Wound Care Strategy Programme (NWCSP).

The Transforming Wound Care programme uses the evidence, learning and recommendations from the NWCSP, aiming to ensure all patients with lower limb wounds receive evidence-based care which leads to:

  • faster healing of wounds;
  • improved quality of life for patients;
  • reduced likelihood of wound recurrence; and
  • uses health and care resources more effectively.


The programme objectives

  • Work across the AHSN Network and with Integrated Care Systems (ICS) to develop evidence-based models of implementation that will help reduce unwarranted variation in lower limb wound care, through innovation and quality improvement.
  • Support ICSs to test models of implementation, ultimately raising the overall standards of care.
  • Support training and development of staff to ensure they have the capabilities to provide required care.
  • Support effective data collection and evaluation activities that help improve understanding and capture learning on how to effectively implement the NWCSP recommendations.


How will we do it?

Each AHSN will work with a ‘Test and Evaluation Site’ (TES) to establish a dedicated Lower Limb Wound Service which suits the needs of the local population.

Our successful TES is NHS Sussex Integrated Care Board (ICB) covering the Sussex Integrated Care System footprint of West Sussex, East Sussex and Brighton & Hove.


The story so far

In Sussex, there is a complex network of services supporting wound management for their population, from primary through to acute and specialist care, with three community providers working with NHS Sussex ICB as part of the TES. NHS Sussex has carried out a stocktake as part of an initial phase of its transformation programme, which is looking at wound care services more broadly.


What’s next?

Following the initial stocktake, the next phase of the Sussex wound care programme will focus on delivery of the lower limb wound clinical pathway based on the NWCSP recommendations for care, using the following key enablers:

  • People: the delivery of training to all staff supporting patients with wounds.
  • Processes: implementing a new evidence-based model based on the recommendations of the NWCSP.
  • Technology & design: supporting data collection and provision of care through a new digital wound management system.

Sussex ICB has had excellent engagement from commissioning and provider organisations across the system for this piece of work and the next phase will see system partners working collaboratively to improve access to equitable, high quality, evidence-based wound care for their population.

Being a TES provides a great opportunity to support provision of the resources and clinical leadership required to drive this work forward and KSS AHSN is looking forward to supporting Sussex with this work.

If you’d like to know more about the programme, please contact