National Wound Care Core Capabilities Framework launched to standardise wound care across all health and care roles in England

Launched today by the National Wound Care Strategy Programme (NWCSP), the National Wound Care Core Capabilities Framework for England has been designed by a multi-professional team and for a multi-professional audience, to be a single, consistent, and comprehensive foundation that will underpin the highest standard of wound care, so that anyone with a wound receives the treatment they need, no matter the setting or location.

There are an estimated 3.8 million people living with a wound in the UK¹, with “many experiencing long-term pain, discomfort and poor quality of life related to their wound,” said Baroness Watkins of Tavistock, Chair of the National Wound Care Strategy Programme Board. “Too often, inadequate care means that these people suffer for longer than is necessary and evidence points to marked unwarranted variation in wound care services, underuse of evidence-based practices and overuse of ineffective interventions.” As a result, she said for those caring for people with wounds, “poor healing rates increase the demand on scarce resources” and the annual NHS cost of wound management is said to be £8.3 billion².

The first multi-professional framework of its kind, the document aims to collectively mitigate this current variation found outside of the pockets of expertise in specialist and community services, by describing the core skills, knowledge and behaviours required by all health and care professionals to deliver high quality, person-centred, wound care. To ensure consensus in identifying these core capabilities, the project developers Skills for Health and Health Education England worked closely with a diverse range of key stakeholders from across the sector.

“Good wound care rests on addressing the interdependencies between the different health and care professionals caring for people with wounds,“ said Baroness Watkins. “Although wound care is often perceived as primarily a nursing issue, all members of the team need to be able to recognise their role in wound management, know how to take appropriate action and how to support patients in their wound care.”

The framework forms a major part of the NWCSP that was established to enable care that is organised and research-informed, to achieve improved healing rates, better experience of care, greater cost-effectiveness and prevent incidence and recurrence.

“Chronic wounds are a significant burden and can impact greatly on a person’s quality of life,” said Professor Mark Radford, PhD, RN and Chief Nurse of Health Education England and Deputy Chief Nursing Officer for England. “It is crucial that every health and care practitioner has the knowledge and skills to provide people with wounds with the right care, wherever they are.”

The purpose of the framework is an overarching one, which does not replace the need for pre-existing publications that provide guidance for care of single wound types, specific professions, or levels of practice, but rather builds on them. “We must build knowledge and skills in line with individuals’ scope of practice,” explained Professor Radford.

Consequently, the core capabilities within the framework are described in three tiers and a practitioner working in a health or care setting, may move between these tiers depending on their role, setting or circumstances.

“Whether as a gatekeeper to a more specialised service, as an expert clinician working within such services, or as someone providing initial or ongoing wound care, this framework supports practitioners in developing and providing evidence of their knowledge and skills,” said Baroness Watkins. “It enables the highest standards of practice as well as providing a structure for career and role development within wound care.”

The framework has already been widely welcomed by nursing leaders, including Dr Crystal Oldman CBE, Chief Executive of The Queen’s Nursing Institute, who particularly noted its significance for District Nurses across England who are at the forefront of delivering complex wound care in homes, requiring a range of expert, specialist skills. She said: “Embedded into community health services this framework has the potential to drive improvements in the way that wounds are managed and treated, promoting healing, and transforming quality of life.”

Jude Diggins Interim Director of Nursing, Policy and Public Affairs at the Royal College of Nursing added: “This framework is an opportunity to clarify roles and responsibilities in what can be a complex clinical situation. By defining the skills and knowledge required by members of the wider Multi-Disciplinary Team, it will help drive up standards of wound care in all settings.”

Further educational resources are currently being developed by the NWCSP to support the implementation of the framework within the existing workforce, as part of a package of NWCSP publications and resources to improve wound care for patients. 

¹BMJ Open (2020), Cohort study evaluating the burden of wounds to the UK’s National Health Service in 2017/2018: update from 2012/2013, Guest JF, Fuller GW, Vowden P: https://bmjopen.bmj.com/content/10/12/e045253

² BMJ Open (2018), Opportunities for better value wound care: a multiservice, cross-sectional survey of complex wounds and their care in a UK community population, Gray TA, Rhodes S, Atkinson RA, Rothwell K, Wilson P, Dumville JC et al: https://bmjopen.bmj.com/content/8/3/e019440