Stop the Pressure: an update from NHS England. Susan Bowler, Professional Advisor NHS England

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1 Stop the Pressure: an update from NHS England Susan Bowler, Professional Advisor NHS England

2 Pressure Ulcer information at a glance There were 2101 recorded Pressure Ulcers in April 2013 There were 1189 PU s recorded in September 2015 On average 6000 pressure ulcers are newly acquired in hospital each month 48% Midlands and East has seen a 48% reduction in all acquired PU s in 2 years 4,638 per pressure ulcer Nurses recognise that improving care outcomes for patients and avoidable harms like PU are key to a high quality and sustainable NHS Ruth May On average each month 27,000 patients will be found to have a pressure ulcer across England

3 NHS Midlands and East regional NO pressure ulcers launch Ambition: To eliminate avoidable grade 2, 3 and 4 pressure ulcers by December National quality indicator and part of operating framework. Identified newly acquired pressure ulcers as a key improvement area Using a care bundle to prevent pressure ulcers CQUIN linked to safety thermometer

4 The campaign 4

5 5 RMayNurseDir

6 Improvements sustained and embedded over time Nationally there has been a 18.5% reduction Regionally There has been a 14.3% reduction (Oxford AHSN) Locally There has been a 87.5% reduction (Maidstone and Tunbridge wells)

7 NHS England - Patients with New Pressure Ulcers 2500 Number of New Pressure Ulcers - Grade 2+ Rest of England April 13 - September Grade 4 Grade 3 Grade 2 Grade 2+ Forecast Trend Number of New Pressure Ulcers - Grade 2+ Midands and East April 13 - September 2015 Change from April 13-22%

8 NHS Midlands and East - Patients with New Pressure Ulcers Number of New Pressure Ulcers - Grade 2+ - April 2012 to September % Grade 4 Grade 3 Grade 2 Grade 2+ Forecast Trend 2+ 8

9 Driving Innovation.. Future Case Study :Chasing zero at Wigan, Wrightington, and Leigh Patients are scanned using a SEM scanner to assess sub-epidermal moisture. The scanners allow the practitioners to identify damage before it can be visibly seen! Over 45 days no pressure ulcers were recorded Case Study : Sally Sore at UHCW UHCW TV team have continued to innovate and develop new methods for teaching including a simulation tool that roves the wards highlighting best practice and offering opportunity to improve knowledge Case Study : Non-Invasive Monitoring of Pressure Ulcer Formation- University of Southampton In conjunction with Eindhaven University of Technology, Southampton University are undertaking research to identify a non invasive monitoring method for PU in spinal cord injured patients. By monitoring biomarkers in urine, they are asking - do these marker concentrations change before a PU becomes visible?

10 What are our priorities going forward? Further Website development Care Homes Economic analysis 10

11 Website development Expert Working Group work stream Transfer to the NHSI website Update to ensure reflects current demand 11

12 Building on the opportunities Innovation to drive reductions in Care Homes PROSPER 58 Nursing / Residential Homes enrolled so far. 40 more due to commence Nov 2015 (cohort 4) 20% reduction in pressure ulcers across care homes 1 Care home 167 days free of PU and a second 200 days free Ideas generated internally Jelly Champions! - Compact Mirrors Your Turn React to Red Coventry Health Economy 1,100 Care staff trained 74 Nursing and Residential homes received training and 4 accredited 20% reduction in grade 2 PU in the community Maastricht visit East Midlands AHSN International LPZ project Pilot of 35 care homes A different way of working University Hospitals Coventry and Warwickshire NHS Trust (UHCW) has put in a enhanced care team of 34 WTE (Healthcare Assistant) posts to help their special and complex care patients. Thereby, leading to estimated direct cost saving of 1million this year and 2million next to the Trust when compared to agency costs or ad hoc savings

13 Future opportunities Financial savings o The Economics team at Monitor are leading a piece of work to undertake an updated economic analysis on the cost of pressure ulcers International results that we can strive for; o New Jersey 70% reduction in new PU Incidence Mission, objectives, focus on prevention Build upon the energy within our system o 18 UK poster presentations at the European Wound Management Conference o Establish a Public Health campaign to raise PU awareness amongst the general public Recognise the power of social media to engage and make change o > 1000 student nurses have attended education events from one twitter conversation

14 Pressure Ulcers UK Supporting the elimination of preventable pressure ulcers Charity No w: PressureUlcers.UK e: 14

15 Please become a #stopthepressure champion and thank you for Or ruthmay@monitor.gov.uk 15 RMayNurseDir

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