Tissue Viability Service (Newham)

The Tissue Viability Service offers a nurse led wound care service to the people of Newham who suffer from both acute and chronic wounds and those at risk of developing wounds such as pressure ulcers. The service operates to provide hands on specialist clinical care, expert advice and education for patients and all stakeholders involved in wound prevention and treatment. The service provides a range of advanced wound treatment interventions to enable people to receive care at home and prevent hospital admission. In addition to providing a community service for patients with wounds at home the tissue viability team support colleagues working in The Trusts mental health settings in Newham, Tower Hamlets and City & Hackney, children’s services, in patient wards at East Ham Care Centre and nursing and residential homes in Newham.

There are currently five Tissue Viability led leg ulcer clinics and one leg ulcer prevention clinics a week and one clinic for the management of lower limb oedema.

The Tissue Viability Service are proud of their healing rates and recurrence rates for venous leg ulcers. Currently our healing rates are on average 86% in 12 weeks and recurrence rates are 2.4%. Nationally figures for healing rates are around 50% in 12 weeks and recurrence rates are reported as 24%.

Recent initiatives and achievements

The Tissue Viability Service was the front-line submission in 2008 for the High Impact Actions ‘Your skin matters’ and were able to demonstrate a reduction in hospital admissions associated with pressure ulcers by 50% with a cost saving in excess of 59K. The team led on a QI Project in 2018 aimed to address the inequalities in the assessment and management of patients with leg ulcers receiving care at home was welcomed and supported by the district nursing teams. These teams have an increasing demand on their time and are expected to deliver a high-quality service. The project was a success and with the support of the tissue viability team new technologies were introduced which simplified leg ulcer assessment.

In 2019, a qualitative research study was undertaken to explore the barriers and enablers to the implementation of evidence-based practice in pressure ulcer prevention and management in a community setting. The findings of this study have been published in Health and Social care in the community journal.

In 2021, a Collaborative QI project where the aim was for a reduction of ELFT acquired pressure ulcers in the community by 10%. The project was a success, and we were able to demonstrate a 31% reduction. Some of the changes ideas were introducing Telehealth monitoring and the use of wound Photography to aid triage of referrals and support correct identification of the category of pressure ulcers. This led to the team being awarded the Silver Prize at the British Journal of Nursing Awards 2023.

How to Prevent Pressure Sores

The Tissue Viability work in collaboration with the Pressure ulcer Improvement facilitators in both Newham and Tower Hamlets Extended Primary Care Services supporting district nurses in the prevention and management of pressure ulcers.

Preventing pressures sores developing involves collaboration with individuals, families and carers, as well as healthcare staff. The tissue viability team have supported the local authority in providing training and education for informal and formal carers working across the borough to raise awareness of pressure ulcer prevention and where to seek help.

Service Lead: Carole Taylor, Lead Nurse- Tissue Viability Service