Getting to grips with the standard

Wound Care
1.
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About this toolkit

2.
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Getting to grips with the standard

3.
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Getting people on board

4.
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Taking stock and planning

5.
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Putting the standard into practice

6.
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Shared resources and learning

Getting to grips with the standard

More than 2 million people in the UK suffer from chronic wounds, which cause pain and discomfort, and impact on an individual’s general wellbeing. 

Treating wounds costs the NHS £5.3 billion a year, and it is nearly as costly as cancer care (£5.6 billion a year)*.

There is an inconsistent practice in UK wound care services, underuse of evidence-based practices and overuse of ineffective solutions. There is a need to improve wound care healing and prevention for people and use NHS resources more efficiently.

*https://pressureinjuryprevention.com/uk-wound-care-cost/
Leg wound care

NHS England commissioned the National Wound Care Strategy Programme to reduce unwarranted variation in care and improve information sharing between clinical settings, professionals and patients.

Standardising generic information in the care record will support the delivery of wound care, including prevention, assessment and management of wounds, resulting in more effective practices.

The benefits

For
people

People

For healthcare
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For
organisations

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A treatment plan, which details what care is going to be delivered, over what timescales and to what effect, designed to meet the person’s preferences.

The treatment plan will be based on the Personalised Care and Support Plan Standard (PCSP), developed with the person to address their overall needs and goals.

Assessments undertaken by a care professional, observations made by a care professional, or by the person and treatments delivered by the care professional.

Support for self-care and self-management, allowing the person to have access to wound care information and education documentation or to share images and documents with the care professional.

The wound care record is dependent on other parts of the care record such as information about the person’s demographics and ‘About Me’ information, previous and concurrent care and information about care professionals or carers involved in the care of the person.

Details of terminology (e.g SNOMED CT) are in the standard implementation guidance. Elements will have a coded item with the value sets showing SNOMED CT or other code system.

The full standard

You can view the full standard on the following page: Wound Care Standard – PRSB (theprsb.org).
Please use the links at the bottom of the standard page under “Current release” to view the 3 domains.      

You will find the detailed implementation guidance in the information models, but it is also important to review the associated general implementation guidance and safety case available under supporting documents on the Wound Care Standard – PRSB (theprsb.org) webpage.

Please see Standards Explained for more information about how PRSB information standards are structured.

How to use the standard

The standard should be implemented in systems that your organisation is using to collect and access information about a person’s wound care. The content of this information is determined by the professional providing wound care and should be in accordance with the National Wound Care Strategy Programme.

Once the information standard has been implemented in your system, health and care professionals should be trained to use it correctly when co-producing or accessing a person’s information in their wound care record.

The information model for the Wound Care Standard includes different levels of conformance:

  • Mandatory: the information must be included
  • Required: if it exists, the information should be included
  • Optional: a local decision is made as to whether the information is included.

 

How the standard fits with personalised care planning

A person’s wound care should ideally form part of their personalised care and support plan so that clinicians have a holistic view of the individual, the conditions for which they are being treated, and their needs and preferences. 

The diagram below shows the wide range of different information that can be captured and should be considered as one holistic plan 

Go to

Introduction
The benefits
Exploring the standard
How to use the standard
How it fits with personalised care planning

PRSB Standards Explained

Why we need standards to record our health and care information in a consistent way so that it can be made available whenever it is needed.

Read More

Making change happen

Transformation programmes need clear goals, the right leadership and engaged staff and stakeholders. Get started by reading our information on transformational change.

Read More

PRSB Support Available

If you have a question for PRSB, please contact our support team. We have an expert team who can help you find the answer, or direct you to the right place.

Read More

CHAT theory also explicitly addresses five areas which if addressed systematically will help overcome stakeholder differences in pursuit of the common goal:

1. Understanding the artefacts that characterise the group and its activity.
• The artefacts might be clinical settings or the forms and templates used to capture and share information. During the pilot we heard about hard copy Dialog response forms; locally generated templates for collating information from different systems; letters and emails to GPs; images, poems or other non-text artefacts that service users might want to include in their ‘about me’ or care plan.

2. Understanding the multi-views of the group. Such groups are always a community of multiple points of view, traditions and interests. 
• Different participants in the group will have different roles and will bring to the group and their roles their own histories, language, and ‘rules’. During our Stocktake preparations and workshops we worked with psychiatrists, mental health nurses, occupational therapists, social workers, transformation leads and voluntary sector representatives, all professions and interests with their own language, approaches professional ‘rules’ but united in their interest in care plans, care planning.

3. Activity systems (like the ICSs) take shape and get transformed over periods of time. ‘Historicity’ is a term coined to express how the group’s problems and potentials can only be understood against their own history. 

 

• ‘We’ve always done it this way’, ‘that didn’t work before’, ‘it’s always like this’, ‘it wasn’t always like this’, ‘they are changing things again’, are all typical statements that often frustrate those charged with overseeing change initiatives. Without addressing the experiences that lie behind such comments you risk repeating mistakes of the past, alienating your stakeholders or just not understanding the real starting point for your transformation project. This is particularly the case for the implementation of the PCSP standard, the success of which will be largely reliant on point-of-care practices and information protocols as well as having systems which are user friendly and appropriately configured.

4. The central role of contradictions as sources of change and development. Contradictions are not the same as problems or conflicts. Contradictions are historically accumulating structural tensions within and between activity systems. Collectively addressing contradictions in how policy, practice, culture and technology interact will empower teams to find genuinely novel solutions for apparently intractable challenges, like interoperability and shared care plan/planning. 

This links to the fifth principle that:

5. the possibility of expansive transformations in activity systems. As the contradictions of an activity system are aggravated, some individual participants begin to question and deviate from its established norms. In some cases, this escalates into collaborative envisioning and a deliberate collective change effort. “An expansive transformation is accomplished when the object and motive of the activity are re-conceptualised to embrace a radically wider horizon of possibilities than in the previous mode of the activity.”