Paul Trueman

Mr Trueman is Vice-President of Market Access Smith & Nephew Advanced Wound Management and Chair of the Eucomed Advanced Wound Care Sector Group.

The general consensus is that the majority of pressure ulcers are deemed ‘avoidable.’ Yet, as we approach another Stop Pressure Ulcer Day (19 November), I see avoidable pressure ulcers still occurring everyday across all sites of care. It seems to me that current guidelines, policies and training programmes are still insufficient to tackle this growing problem. Together with my industry colleagues, I have been calling for the inclusion of wounds, and particularly pressure ulcers, in national patient safety policies throughout because they are preventable . Pressure ulcers are an adverse event that have high costs for patients and health systems. Given the impact of pressure ulcers on health systems, I continuously have asked, “Why isn’t more being done to stop pressure ulcers? How can we support better prevention?” The fact is that preventing pressure ulcers, and wounds in general, means working across care silos and ensuring that healthcare professionals from all disciplines know how to manage at-risk patients. Prevention of pressure ulcers also means focused training and specialised care when necessary which requires investment at a time when many health systems are focused on cost-containment. Yet, we know that additional investment will be more than recouped through the avoidance of extended hospital stays and ongoing care. Surely, the avoidance of adverse events and complications results in benefits for both patients and health systems. Under the Italian Presidency, Member States called on the Commission to work towards a better understanding of the cost-effectiveness of patient safety policies, but little has been done since the adoption of the Council Conclusions to promote long-term investment in patient safety generally – much less specifically for the prevention and management of pressure ulcers. I therefore believe that as stakeholders we must urge both national and EU policymakers to commit to, and invest in, patient safety...
The European Parliament adopted another report this week focused on safety in healthcare highlighting the huge costs to healthcare systems, not to mention the enormous costs to patients, for preventable injuries, complications and infections. While I admire the Parliament’s attention to these issues, it is still clear that many of the calls for improved monitoring of patient safety and mitigating steps to avoid such events still fall on deaf ears at the national level. This is particularly relevant to the wound care community, given the stubborn incidence of pressure ulcers and surgical site infections which occur in healthcare facilities. Patient safety in wound care Safety is especially important in wound care where appropriate treatment can help prevent the development or prolongation of a wound as well as adverse outcomes such as infection or amputation. Advanced wound care treatments have a significant role to play in the prevention of patient safety events such as pressure ulcers and surgical site infections, particularly in hospital settings. When managed inappropriately these events can result in avoidable morbidity, extended hospital stays and even mortality. While the EU institutions recognize at a macro level that appropriate care and treatment can deliver improved efficiency – essentially improved outcomes at lower cost - at a national level the focus remains on cost containment. Driven by austerity measures and increasing demands, most healthcare decision makers revert to managing budgets on a short-term basis and look for cost savings, particularly in the procurement of medical supplies. This issue is worsened by an absence of accurate, routinely collected data on patient safety events across many EU health systems. Whilst some health systems, such as the English NHS, have implemented data collection on pressure ulcers and surgical site infections, this remains highly variable across member states. The absence of data means that...
When the European Commission published its secondary report on patient safety, it made me wonder why advanced wound care is not higher on the patient safety agenda at EU and national levels? Not that it’s a competition, but the incidence of wounds in the EU is approximately 4 million (!), which is on par with cancer (3,9 mill), cerebrovascular disease (3,9 mill), and diabetes (2 mill.). The wound care debated has progressed for sure, but there’s much more do to be done to make sure than wound care in Europe gets the attention it deserves. The EU’s on the right track, but…
Despite the overwhelming impact that wounds have on healthcare systems, many people are still unaware of the risks for developing wounds when entering a healthcare setting. In fact, 27-50 percent of acute hospital beds are likely to be occupied on any day by patients with a wound. Many of these patients will be at high risk of infection, which can result in extended hospital stays and for some, amputation. Yet, patients can be better protected against such risks by instituting evidenced based guidelines in healthcare settings that include multidisciplinary approaches to wound care treatment.