Commissioners and GPs

Leg Clubs are a model of care that every commissioner should be considering as not only do they support Domain 2, 3, 4 and 5 of the NHS Outcomes Framework, they can help CCGs meet Quality Premium target areas. The benefits of commissioning Leg Clubs are numerous.

We asked our friends, partners and trustees.....what is a Leg Club?

High Intensity Focused Ultrasound Echotherapy treatment for varicose veins and venous leg ulcers

SONOVEIN® Echotherapy is the most recent technology available for treating varicose veins and venous leg ulcers. It uses the latest developments in ultrasound technology to treat the veins from outside the body, making it 100% non-invasive.

How does it work?

A high-intensity ultrasound beam is focused on the problematic vein. As the beam is delivered the affected vein shrinks and is sealed closed.  An ultrasound probe at the front of the SONOVEIN® machine ensures total accuracy of treatment as the vein can be seen in real-time. This enables clinicians to follow even the most tortuous of vein paths regardless of their shape or size. Even notoriously difficult to treat perforator veins, including those leading to open ulcers or recurrent varicose veins can also be treated without the risk of infection.

As SONOVEIN is completely non-invasive patients are homeward bound as soon as the treatment is completed.


Venous Leg Ulcers: A Silent Crisis

All-Party Parliamentary Group on Vascular and Venous Disease Parliamentary Launch – Venous Leg Ulcers Report
 
The document: Venous Leg Ulcers: A Silent Crisis held at the House of Commons on 15th October 2019 brought  together clinicians, patient groups and NHS leaders for the launch of the APPG’s report on venous leg ulcerations. Central themes of the report include patient and clinical perspective on standard of care, barriers to access, and recommendations. The launch was introduced by Derek Thomas MP and the introduction of the venous Report was presented by the Secretariat of the APPG as well as specialist clinicians involved in the writing of the report.

Click here to view the report.

Ration Watch

Launched at MedTech Week 2018 was the new website and resource Ration Watch. Following the information from Freedom of Information Requests, a call for data from MTG members and phone calls with the MTG the Ration Watch website was launched, highlighting arbitrary thresholds which have been implemented across a range of CCGs. The website can be found here: www.rationwatch.co.uk

The Implementation Framework for the NHS Long Term Plan

The framework for the NHS Long Term Plan was published 27th June, 2019 and can be accessed here.

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.

National Wound Care Strategy Programme (NWCSP)

Care that is well-organised and research-informed improves healing rates, achieves better patient experience and makes better use of scarce NHS resources.  However, UK wound care varies widely.  Too often patients are not offered treatments that are known to be effective and too much trust is placed on treatments which lack such evidence.    NHS England is funding the National Wound Care Strategy Programme (NWCSP) to scope and develop a national wound care strategy for England with a focus on;

1.           Pressure ulcers,
2.           Lower limb wounds, and
3.           Surgical wounds.

We are identifying national standards of care that will reduce unwarranted variation, improve safety and improve patients’ experiences of care.  We are also working to ensure that the right wound care products and treatments reach the right patients at the right time, seeking to improve education for clinicians, patients and carers and developing better ways to measure care so we can improve care.  We are consulting with stakeholders throughout this process and would welcome feedback from anyone with an interest in wound care.  Please sign up to a Stakeholder Forum at www.nationalwoundcarestrategy.net.

 

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.
Further Information:

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

 

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.