Achieving sustainability in tissue viability

Sustainability has become a defining priority for healthcare in the United Kingdom, driven by rising demand, workforce pressures, financial constraints, and the National Health Service (NHS) commitment to achieve Net Zero carbon by 2040.¹ For the NHS, sustainability is not confined to environmental considerations alone; it also encompasses the ability of services to deliver effective, safe, and equitable care in a way that can be maintained for future generations. Few areas illustrate this challenge more acutely than lower limb management.

Chronic venous insufficiency, lymphoedema, and leg ulcers place a substantial burden on NHS resources, both financially and in terms of workforce deployment. Wound care overall is estimated to account for around £8.3 billion in annual NHS expenditure and with 560,000 individuals recorded as having venous leg ulcers (VLUs), the management costs exceed £3 billion per year.2 Lower limb wounds are the most prevalent chronic wounds managed within NHS England, affecting over one million patients nationwide, approximately 2% of the adult population.

Traditionally, lower limb wound care has been delivered exclusively by healthcare professionals, often requiring multiple home visits per week. This approach is highly resource intensive and financially unsustainable.² Rising prevalence, workforce pressures, and the increasing emphasis on patient-centred care underscore the need for alternative models that optimise efficiency while maintaining quality outcomes. Within this context, our Trust recognised the opportunity to deliver a model of care that could maintain safety and quality while reducing dependence on routine nursing input.