Patient Safety Collaborative (PSC)
The WMPSC supports members with innovative solutions to help deliver on improving patient safety.

Ideas (Publish, Detailed Submission)

Innovation 'Elevator Pitch':
Leg ulcers are common, impact negatively on quality of life and require frequent nurse-led interventions, which are often task orientated. The LUCT is patient focussed, developed by patients and promotes person-centred consultations.
Overview of Innovation:
A four-stage empirical research project was undertaken between 2009 - 2014 which evidenced the impact that having a chronic venous leg ulcer (CVLU) had on the quality of life (QoL) of the person. During unstructured interviews, participants openly spoke of the devastating impact of these intractable wounds; speaking of pain, odour, exudate, social isolation and recurrence, with one lady having had recurrent ulcers for 60 years.
Despite such open and frank disclosure, observed consultations with the same participants with their nurses revealed a lack of disclosure of those same themes, with, in some cases, participants saying they were comfortable, despite disclosing at interview that they were in agony and were unable to sleep due to pain. Issues with a psychological underpinning were least likely to be raised, disclosed and explored; especially worrying in view of the longstanding nature of this condition. On many occasions issues were not raised by the nurse or disclosed by the patient.
A nominal group, including patient representation, was undertaken and during the meeting a simple, patient-led, consultation template, the LUCT, was developed to direct the nurse and the patient to discuss and act on issues that were impacting on the person's quality of life.
A small-scale pilot of the template indicated a positive trend of improvement in both consultation satisfaction and QoL outcomes (SF12 and EQ5D).
The template is currently being used across several regional Trusts, in either paper or electronic form. Indeed, paper copies can be completed by patients or carers, between visits, to ensure that key issues are captured, discussed and acted upon. The template is aimed to promote problem solving in relation to the issues raised, rather than simply discussion.
Feedback has been positive, indeed, when used in a wound care clinic alongside a Vascular Surgeon, care was changed in relation to patient responses in 8 out of 9 of the cases reviewed.
The LUCT is a simple template that gives the person with leg ulceration a voice during their comnsultations, allowing them to direct their care to issues that really affect them. 
Stage of Development:
Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)
WMAHSN priorities and themes addressed: 
Long term conditions: a whole system, person-centred approach / Innovation and adoption / Person centred care
Benefit to NHS:
Patient engagement, empowerment and self-management are all evidenced themes that lead to health benefits and improved QoL for patients with a variety of long term conditions. Such issues are central to the management of chronic wounds - a condition that, by its nature, is long term for many sufferers. The LUCT is the first and only QoL template available for patients with a chronic wound.
Issues surrounding concordance in the management of long term, chronic wounds are known to impact on healing, symptom management and the patient experience. The LUCT prompts the patient to disclose their concerns, allowing a more open discussion during their consultations and ensuring that the issues key to that patient are addressed by the consulting clinician. 
The LUCT is inexpensive, simple to complete and facilitates a more efficient consultation. A paper copy can be completed by the nurse or patient/carer or in some Trusts the LUCT is now available electronically. Completion is recommended every 4 weeks or as a person's condition changes, with clinicians being encouraged to document the actions taken to remedy an issue that has been disclosed rather than just to record the issue.
Effective person centred care for those with chronic leg ulcers, puts the patient at the centre of the consultation. This process is facilitated using the LUCT. Indeed, since the LUCT is generic to all wounds, some Trusts have adopted it as a chronic wound template for all wounds including leg ulcers, pressure ulcers, diabetic foot ulcers, rather than just limiting application to those with leg ulcers. It is proving to be valuable across these wound types, since their impact on QoL are similar.
Initial Review Rating
4.20 (1 ratings)
Benefit to WM population:
Widespread implementation of the LUCT to all patients with chronic venous leg ulceration or chronic wounds will ensure a person centred consultation is undertaken and that each patient has their specific needs in relation to QoL considered. The LUCT is applicable across all geographic areas where there are patients with this long-term condition.
Current and planned activity: 
Currently the LUCT is being used across University Hospital of South Manchester and is ready to be rolled out in Staffordshire and Stoke-on-Trent Partnership Trust and North West Boroughs Healthcare NHS Foundation Trust. 
The aim now is to get more Trusts engaged and using the LUCT since this is the only template within wound care that focuses the consultation on the quality of life issues.
What is the intellectual property status of your innovation?:
The LUCT was developed as part of a funded PhD at Keele University.
The LUCT is copyright is as follows: 
© 2017 Keele University. All rights reserved
Return on Investment (£ Value): 
Return on Investment (Timescale): 
Ease of scalability: 
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Julie Green 13/10/2017 - 08:57 Publish 1 comment

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