Tissue viability
that patients were never left without access to professional advice. Feedback mechanisms allowed both staff and patients to voice concerns, and where necessary, the model and management pathway was adjusted accordingly. This collaborative, iterative approach ensured that change was not imposed but co-created, fostering a sense of ownership among all stakeholders.
Impact of the initiative The preliminary outcomes of the SWBH LUSCM are promising. Data from the first two community nursing teams to adopt the model demonstrated its impact, and the approach has since been rolled out across all six teams. Data from the first two teams over a six-month period, highlight 17 patients were identified as suitable for the model, of whom 13 achieved complete healing, representing healing rates comparable to, or exceeding historical norms. The average healing time was 10.9 weeks, reinforcing the clinical effectiveness of the approach. Importantly, the initiative also delivered measurable workforce efficiencies, saving an estimated 188.5 hours of nursing time when compared with the traditional model of three visits per week. Product use centred on using the L&R
ReadyWrap and L&R Activa or ActiLymph hosiery kits, which supported both the clinical and self-care elements of treatment and long-term management. Beyond clinical outcomes, patients reported increased autonomy, confidence, and satisfaction with their care. The combination of structured self-care resources, compression
Fig.6 My Leg Diary
application aids, and ongoing virtual support enabled patients to actively participate in their wound management, improving adherence and facilitating early recognition of complications. From a sustainability perspective, the
programme reduced travel requirements, lowered resource consumption, and freed clinical time for more complex cases. These improvements also suggest a potential reduction in carbon emissions, aligning the model with NHS England’s broader Net Zero ambitions.1
Lessons learned Key lessons emerged from the SWBH LUSCM pilot. Firstly, patient selection and education are critical; not all patients are suitable for full self- care, and capacity and capability assessments
are essential. Education emerged as the cornerstone of the initiative. For self-care to be effective, patients needed information that was not only accurate but also accessible and easy to understand. Step by step guides using clear images and plain language allowed individuals to reinforce learning at home. Secondly, clinician engagement is vital; success depends on staff understanding and confidence, alongside willingness to adopt new ways of working. For many nurses, the traditional model of care had been one of direct, hands-on intervention. The idea of patients managing compression therapy independently was initially viewed with caution. Concerns were raised about safety, the risk of non-adherence, and the potential for inconsistent outcomes.
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