Benefits for The Healthcare Team
Data recorded over a 10 year period illustrates wide-ranging benefits for the care provider:
Costs
Apart from the cost of nurses, treatment and dressings (which would have to be met in the absence of the Leg Club), and a nominal charge for an annual audit, there are no costs to the PCT. Leg Clubs are staffed by volunteers from the local community, including a steering committee, who provide services such as administrative support, refreshments and transport. Fundraising within the community provides for hiring of premises and the purchase of specialised equipment such as Doppler Ultrasound Devices, medical cameras etc., often supplemented by support from the healthcare industry.
Savings
Detailed cost tracking has demonstrated substantial savings for the National Health Service. For example, comparison of total cost of treatment at a rural Leg Club versus home visits showed an average saving of around 85% (home visit c£65, Leg Club £8.15 per patient treatment). Leg Clubs also provide an excellent opportunity to enhance the productivity of junior grades through the application of skill mix. For clinicians, a significant reduction in unproductive travelling time allows specialist expertise to be optimally deployed.
Typically within 3-6 months of opening a Leg Club, significant additional savings arise as a result of the changing treatment profile. In an environment of high healing rates and very low recurrence levels, the composition evolves from inherited high levels of active treatment to an ongoing regime of cost-effective prevention and maintenance.
Quality and performance metrics
Systematic demographic, clinical and financial audit via standard templates is a key feature of Leg Club practice. Protecting members' anonymity through a simple referencing system, the information is collated and analysed, and key measures and trends reported. Results are fed back to the individual Leg Clubs, enabling them to monitor their own function and benchmark against others. These reports are available to the participating PCT.
Patient quality of life
Research has demonstrated significant improvements in a range of 'quality of life' indicators for patients attending Leg Club compared to those receiving home treatment. 4 Benefits were recorded in measures of healing rates, pain levels and patient morale.
Staff morale, teamworking and networking
Community nursing tends to be solitary occupation with few occasions for teamworking. Experience has shown that Leg Clubs offer an ideal opportunity for nurses not only to work together with a common goal, but to truly 'get to know' the community they serve. There are many examples of enthusiastic motivated teams developing as a result of the shared challenge and satisfaction of setting up and running a successful Leg Club. On a wider scale, the Leg Club Forum allows Leg Club nurses from around the UK and overseas to meet and share experience and best practice and provides a support network to which they can refer for help and advice.
Best practice guidelines, training
Leg Club staff work to defined best practice guidelines developed in conjunction with some of the country's leading woundcare specialists. Patients and care providers can therefore be confident that all Leg Clubs operate within a consistent framework for quality assurance and standards of care. Prior to setting up a Leg Club, nurses receive training on all aspects of the documentation. There are also woundcare theory and practice workshops as appropriate. There is no charge for training. Additionally Leg Club Forum study days provide training update on developments in areas such as treatment, equipment and woundcare products.
Health promotion, prevention and early treatment
Self referral is consistently one of the most common sources of attendance at Leg Clubs. The easy access, unintimidating environment encourages people of all age groups to seek advice when they might not consider attending a formal clinic or surgery. This presents ideal opportunities for opportunistic and early diagnosis, health promotion and prevention of more advanced leg problems.
NHS strategy
PCT's participating in Leg Clubs concord with key themes of recent government health care strategy. For delivering true patient empowerment and informed patient choice, the model was publicly endorsed by the Secretary of State for Health at the 2004 RCN Congress.
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