Commissioners and GPs

Leg Clubs are a model of care that every commissioner should be considering as not only do they support Domain 2 and 5 of the NHS Outcomes Framework, they can help CCGs meet Quality Premium target areas. The benefits of commissioning Leg Clubs are numerous.

Cost effectiveness:
Leg Clubs offer a cost effective alternative to traditional models of care. Placing nurses in Leg Clubs once a week as opposed to making individual visits to patients can make considerable savings. Furthermore, as the Clubs are operated on a walk-in basis there are no did not attend (DNA) appointments and little time is wasted.

  • With over 2,300 members, Powys Teaching Health Board has registered net savings of £705,744 excluding dressings and equipment
  • Barnstaple Leg Club has estimated at a minimum saving of £10,527 per every 100 patients compared to traditional leg ulcer treatment.


Healing:
Within 12 months of Barnstaple Leg Club opening, half of the 30 patients who had been referred by a GP or community nurse to the Leg Club had healed leg ulcers. In a clinical setting an average healing rate of just 10 per cent would be expected.
Leg ulcers are half as likely to recur in patients attending Leg Clubs as in the national average. 

Prevention:
The model delivers an innovative well-leg prevention programme which not only meets many aspects of the current Department of Health QIPP agenda, but is referenced by the QIPP programme as a being a community-owned model of care that improves healing, reduces recurrence and offers a cost-effective framework for the treatment of lower leg problems. 

Enhancing well-being:
The Leg Club model has been shown to improve the wellbeing of members. Volunteers work with nurses to create a social dimension to treatment, which tackles the problem of social isolation - an issue for the elderly and especially those with leg ulcers. This results in a holistic approach to their care which is missing from traditional leg ulcer management.

Managing co-morbidities:
Leg Club members may have additional long term conditions. The Leg Club model offers the opportunity for co-morbidities to be assessed and subsequent treatment to be arranged. Some Leg Clubs also use their sessions to offer flu vaccinations and nail cutting services. 

Clinical governance:
The Lindsay Leg Club Model has adopted the essential elements of good clinical care: staff training, use of evidence based guidelines, and quarterly audit of processes and outcomes.

Patient satisfaction:
In 2012 a study of five Leg Clubs demonstrated that:

  • 67 per cent of members were better able to cope with life
  • 68 per cent of members felt better placed to keep themselves well
  • 75 per cent of members felt more able to understand their leg problems
  • 76 per cent of members felt better able to cope with their condition
  • 91 per cent of members enjoyed the social interactions


NHS Outcomes Framework:
Commissioning looking to achieve Domain 2 of the NHS Outcomes Framework: Enhancing quality of life for people with long-term conditions, must provide guidance and support for self-management. The Lindsay Leg Club Model puts this at its core with its well-leg programme and in addition provides encouragement and motivation through peer support. This is a major factor in reducing cost, improving healing rates and reducing recurrence. Domain 5 of the Outcomes Framework concerns treating and caring for people in a safe environment which is at the heart of the Leg Club model.

 

Introduction to a Leg Club

View our video below, giving you an insight into the work of the Leg Club. The video was filmed at the Bradford Upon Avon Leg Club.
 

​Case Study – Barnstaple Leg Club

Within 12 months of opening of the 30 patients who had been referred by a GP or community nurse to the Leg Club, half had healed leg ulcers. In a clinical setting an average healing rate of just 10 per cent would be expected.

More impressive is that in those 12 months there was a 0 per cent recurrence rate in those Leg Club members whose leg ulcers have healed. In 18 months only 7 per cent of members had suffered from further ulceration. The cost savings of running Barnstaple Leg Club compared to traditional leg ulcer treatment have been estimated at a minimum of £10,527 per every 100 patients. 

Leg Club members have reported high levels of satisfaction through patient questionnaires. Some respondents provided statements in their feedback which evidence how truly life-changing the Leg Club had been for them. One member said: “Before I was referred to the club I had not left my house for three years.” Another was even more clear about the difference it had made: “Thanks to the nurse and her team and the Leg Club I won’t lose my right leg.”
The social interaction and intervention combined with the above average healing rates shown by Barnstaple Leg Club prove how immensely successful and effective the Leg Club Model can be. NEW Devon CCG has been so impressed by the Leg Club outcomes that it is undertaking a scoping exercise in order to develop the model across its Northern Locality.