Living with a leg wound which won’t heal can have a big impact on both physical and mental health. But a pioneering new drop-in at South Bristol Community Clinic is dedicated to getting patients back on their feet again. Community Health News reports.
It was about a year ago that Pat first noticed the tender area on a varicose vein on her leg, after a trip to the gym. It stubbornly refused to heal, becoming a red, open sore which throbbed for month after month. “I always knew it was there,” says Pat, “and I knew it wasn’t right.”
The sore on Pat’s leg was fast becoming a leg ulcer, which affects about 1 in 50 people over the age of 80 in the UK. A leg ulcer is defined as a long-lasting (chronic) sore that takes more than four to six weeks to heal. They usually develop on the inside of the leg, just above the ankle.
A venous leg ulcer is the most common type of leg ulcer – it relates to problems with the veins and becomes much more common with age. It is estimated that the NHS spends £5.3 billion on managing wounds and associated conditions every year.
A pioneering approach
Pat tried to deal with the problem herself for a year with her own creams and dressings, but there was no change. When she was diagnosed earlier this year with diabetes and advised to improve her diet and exercise more, she knew she had to get her leg healed for good.
When she heard about our new South Bristol Community Clinic in Withywood, a weekly drop-in session for patients with lower leg wounds, Pat thought she’d give it a go. At the clinic, which is based at a community centre, several patients can be treated by dedicated clinicians at the same time. This avoids the need for patients to book weekly GP practice appointments to have their dressings changed.
“So I went along, and it was brilliant,” says Pat. She went every week, and for the first time in a year started seeing clear improvements. “Staff were so professional and knowledgeable about the leg,” she says. “On my first visit they used a Doppler [a hand-held ultrasound to measure blood flow], then they decided on exactly the right dressing for my leg. They gave me specialised compression stockings to help stimulate blood flow to the wound. As soon as I had those on it made a huge difference. It started healing straight away.”
For Pat, it was a relief to know that she was getting the best advice – “everyone else there felt the same,” she says. “And because the clinic is drop-in, you don’t have to worry about making an appointment at a particular time. You can go when it suits you.”
The Community Clinic is designed to help patients relax and socialise, from the way the chairs are arranged, to the tea and cake that is on hand. Age UK Bristol is working in partnership with Bristol Community Health to deliver the non-clinical aspects of the clinic. Volunteers welcome patients and create a friendly social space where people who share the same health conditions can provide support for each other. Volunteers can give information about other local community activities and connect people to support services which can help people to feel less isolated. Shamim Baloo, Age UK Bristol’s volunteer coordinator, is keen to recruit more volunteers: “This is a great way of contributing to an exciting community-based health project,” she says.
Leg ulcers can hugely affect quality of life, says the clinic’s lead wound nurse Val Helliar, not just because of the pain but also because the wound can leak and smell and really knock social confidence. “For patients, finding out that they are not alone with this and talking about it with other people can be a huge boost,” says Val. “They often find that it’s more common than they think. And as soon as they get the right compression treatment this helps with the leakage too,” she says.
When Pat visited she felt that the clinicians had time to give good care in a holistic way: “They were so friendly, really listened and asked me how I was feeling as well as looking at the wound itself.” As David Pugh, operational manager for the South Bristol Community Clinic, puts it: “The clinic is not just about leg ulcers. It’s an opportunity for us to listen, watch and pick up other issues at the same time.”
For Pat it was particularly important to get the ulcer healing quickly because she was booked in for a knee replacement operation. “Everyone at the clinic was committed to making sure the ulcer was fixed in time,” she remembers. “They helped it heal but then it broke out again – and Val personally did everything she could to get on top of it again. Three weeks later I was able to have my knee operation, which went really well.”
The aim is to make sure that patients’ wounds not only heal, but stay healed. This means helping patients understand their condition so they can be in more involved in managing it. “We want to educate and empower people so they understand when they should come in to be assessed,” says David.
Knowing the clinic is there is peace of mind for Pat, who says that if she gets another ulcer she would go there straight away to get on top of it much earlier. “It’s a brilliant service – I can’t fault it really.”
South Bristol Community Clinic: what you need to know
The South Bristol Community Clinic is for patients with non-healing lower leg wounds who are registered at the following GP clinics: the Lennard Surgery, Grange Road Surgery, Hillview Family Practice, Crest Family Practice, Hartwood Healthcare and the Merrywood Practice. The clinic takes place at the Withywood Centre, BS13 8QA on Thursdays between 9am-12pm. You don’t need an appointment – just drop in at any time during the session.
The clinic is being trialed for 12 months from April 2017 and is funded by Better Care Bristol and Bristol Ageing Better. If you are interested in becoming a volunteer at the clinics, please call Age UK Bristol on 0117 929 7537.