Our new service to provide wound clinics at GP surgeries gives patients fast access to specialist nurses, on their doorstep. It’s better for patients and reduces demand for GP appointments.
Patients with complex and non-healing wounds can take up a lot of time.
But by working with us, we can give you that time back, to spend with other patients who need you. We will also spend time with your practice nurses, whose skills we can develop and nurture.
Tried and tested
We ran a pilot of our new Wound Medicine Centre Outreach Clinics, in Tonbridge, in December 2020. The service was welcomed by GPs, practice nurses and patients, which is why we are now rolling it out across west Kent. We are hoping we will soon be able to offer a service in the east of the county too.
We are the experts
Stephanie Rhodes, KCHFT’s Head of Long Term Services in west Kent, said: “With this service, we can bring our expertise to you. We have the very latest diagnostic equipment. We work with the patient and practice nurse to agree the best treatment plan, using the most appropriate dressings to offer good outcomes for patients. We are able to use our expertise when it comes to the latest guidance and best practice.
“We know dealing with complex wounds and ulcers takes up a lot of GP time and really impacts on patients’ wellbeing and confidence, which in turn can affect their health. Our support can alleviate much of this, as well as time pressures for practices.
“This also works better for patients, who are able to access specialist and expert care locally. Patients get expert assessment and when they are given the most appropriate treatment, as early as possible, healing times are reduced and they get better outcomes.”
How it works
Regular clinics are set up at GP surgeries. GPs and practice nurses refer patients to the clinic. Our specialist nurses offer a one-hour initial appointment, at which the practice nurse would also be present. Working together, our nurse specialist and your practice nurse draw up a shared care plan with the patient, which also takes into account the patient’s lifestyle, including diet and exercise. The practice nurse continues to see the patient, having our specialists as back-up if needed. Our nurses see the patient at the clinics, for regular reviews.
Stephanie said: “We complete a holistic assessment and use our wound matrix software, which involves taking photos of the wound at regular intervals and taking measurements.
“This helps us to clearly see improved healing and encourage patients with the treatment options. We have a first choice dressing formulary to make sure we use what is most appropriate and what will result in the best outcome for the patient. Our nurse uses the GP IT system together with the practice nurse, so notes are held in the patient’s records, for the GPs to view.
“Wound care is a large part of what we do within community nursing care and many nurses have a special interest and expertise, providing this skill every day.
In addition to the clinics, they work at our wound units attached to community hospitals. These units are centres of excellence.
“During the pilot, GPs said they welcomed our specialist nurses going to their practices and working closely with practice nurses to support and develop them.”
If there’s a better nursing team on this planet, I’d like to meet them, as they must be pretty special.”
Leslie Dixon, 85, has been thrilled with the treatment he’s received at his local wound clinic, which he has described as “magic”.
As well as the expert care he’s had, Leslie is also pleased to have been able to have his treatment just a short walk from his home.
Leslie first developed venous eczema early in 2020, before the COVID-19 pandemic. With treatment from his GP and practice nurse, it initially cleared up, but it returned again later in the year. He was then given an appointment at a wounds clinic which is held at his GP surgery once a month, thanks to a collaboration between Kent Community Health NHS Foundation Trust (KCHFT) and Tonbridge Primary Care Network (PCN). The new clinic, at Woodlands Health Centre, has been running since December 2020.
Leslie said: “It started with a terrific pain in my leg and I thought I had pulled a muscle. That went away but returned a week later. I then noticed two or three wounds on my lower leg which started weeping and were very painful.
I’ve been overwhelmed by the expert attention and specialist care I’ve been given. I’ve been treated by my practice nurse, who I know well and also by specialists who are experts when it comes to wounds. When I ask a question they always know the answer. I feel very lucky. I am full of praise and I’m hoping I’m now on the mend.”
At times during his treatment, Leslie had to wear very thick dressings, which made putting on shoes and driving impossible, so he was pleased to be able to access treatment and support on his doorstep.
He said: “I’m very grateful to have been able to have my treatment at my doctor’s surgery, rather than having to travel to a hospital. This wouldn’t have been easy, as my wife no longer drives and there have been times when I haven’t been able to.
For hospital appointments we had to rely on my daughter coming down from London to take us.
“I told the nurses that I rely on driving to do things like getting the shopping, so when they were able to, the nurses put on a dressing which allowed me to drive. I am so grateful.”
Julia is a practice nurse at Woodlands Health Centre and Tonbridge Primary Care Network (PCN) lead nurse. Tonbridge PCN has five practices, covering Tonbridge, Hildenborough, Hadlow and Paddock Wood.
She said: “For our patients, it means they no longer have to travel to the Sevenoaks Wound Centre, which is an excellent resource, but it might not be convenient for everyone.
Wound care medicine nurse Clare Eagleson
“Some patients do not have cars and we also have patients who don’t drive because of their wounds. For some, travelling to Sevenoaks could mean taking two buses. When patients might not be very mobile, or may be older, or if they don’t like to be around other people, as their wounds might have an odour, this isn’t easy.
“Having a regular wound clinic at their local surgery makes things a lot easier for them.” Regular wound clinics are held at each practice, on rotation.
Julia said: “As practice nurses, we do many different things and see a variety of conditions and ailments, whereas the wound medicine centre lead nurses, who we work with at these clinics, are experts in this field, with very specialist knowledge. We’ve been learning a lot from them, which is great for upskilling our staff.
“The wound medicine centre lead nurse carries out the one hour initial assessment, with the GP practice nurse working alongside them and a care plan is set up.
The practice nurse then looks after the patient at further appointments until a review is needed, when they would see the specialist wounds nurse again.
“The specialist nurses leave instructions and we know they are at the end of the phone if we need any further help or advice.”
Kent Community Health NHS Foundation Trust also provides a wound clinic for the Tonbridge Medical Group. GP partner GPs, Dr Laura Mawson, said: “The wound clinic provides an excellent service and is extremely beneficial to our patients. We are grateful to be able to draw upon their expert knowledge and skill set.”