Community Wound Care Transformation

Community Transformation: Wound care at point-of-care  

Project completed as part of Wrightington, Wigan and Leigh (WWL) Green Team Competition 2025. 

Team members:  

• Elaine McDowell, Head of Business Development & Transformation in the Community Division of WWL 
• Paula Shenton, Project Manager, Community Transformation Team 
• Emma Fisher, Team Leader, Treatment Room service  
• Colin Carruthers, Community Stock Manager 

Community Division with ICB, District Nursing & Treatment Rooms, Corporate Finance/Procurement/Quality, Estates, Governance. 

Setting / patient group: 

Patients requiring wound care who attend community treatment rooms.  

Issue: 

Community wound care dressings were provided through a prescription system, where nurses had to request items via a paper form that was sent to a prescriber. The prescriber would then write a prescription, which was sent to a pharmacy. Patients had to collect the dressings themselves or wait for delivery, often facing delays if items were out of stock. This process was funded by the Integrated Care Board. However, this system created multiple problems: patients sometimes missed appointments due to unavailable dressings, had to store and carry bulky items, and those without stable housing struggled to access care. Prescribers spent significant time on non-medical prescriptions, and pharmacies often dispensed full packs even when only a few items were needed, leading to waste. Monitoring whether staff followed the recommended product list (Greater Manchester Wound Formulary) was also slow and difficult.

Intervention:  

Aim: To transfer the process for managing and providing wound care formulary to WWL Community Division, removing the need for prescriptions and enabling supply at the point of care. 

A pilot was launched in Treatment Rooms, with dressings ordered via NHS Supply Chain and funded provided to the Trust from the ICB. Products were standardised to the Greater Manchester Wound Formulary, and new operating procedures were developed. Band 3 Stock Managers were recruited to oversee stock management, expiry dates, and redistribution across sites. The pilot included changes to procurement, storage, and clinical workflows, with plans to expand to District Nursing services in later phases.

Outcomes: 

Wound care dressings are now provided to patients at the point of care, instead of via prescription services in Community Treatment rooms, which prescribe an average of 150,000 dressings for patients per year. 

Clinical: 

• More timely and efficient care - reduced DNAs and cancellations anticipated
• Improved consistency and availability of appropriate dressings - may optimise wound healing progression.
• Reduced admin frees senior staff which shortens waits and improves patient access.
• Improved equity of access for hard-to-reach groups (e.g. homeless, traveling communities)

Environmental: 

• 1,991 kgCO2e per year. Saving equivalent to driving 5,858 miles (average car)

Financial: 

• £103,023 per year. 

Social:

• Patients save £9.90 per prescription item
• Convenient for patients (reduced travel, no need to stock items at home and carry heavy items to appointments). 
• Reduced missed/rescheduled visits
• Significant staffing time and cost saving for prescription writing (1.4 Full time equivalent) 

Key Learning Point

Large-scale service transformation is achievable when system partners share a clear understanding of the problem and are committed to collaborative change. Support from senior leaders and integration into existing workflows were essential to success. Using Treatment Rooms as a pilot site allowed logistical challenges to be addressed early, and PDSA cycles enabled iterative improvements. Partnership working, particularly with Health Outreach and Inclusion Service (HOIS) and financial teams, was critical to navigating complex funding transitions. The initiative showed that aligning clinical, operational, and sustainability goals can deliver meaningful change, but ongoing engagement and review are needed to embed and expand the model.