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Influencing service design to boost care

Clinical commissioning groups (CCGs) are starting to recognise community nurses as a great asset. However, it is important for nurses to influence service development by engaging with CCGs.

Leg Clubs are community-based leg ulcer clinics, which operate in a non-medical social setting. Evidence shows the Leg Club model leads to improved healing rates by encouraging members to become more involved in their care.

More than 80% of all leg ulcers are treated in patients' own homes by district nurses or by practice nurses in GP surgeries. However, patients often find it difficult to stick to treatment plans, or maintain preventive measures needed to avoid the recurrence of the ulcer.

By healing chronic leg wounds and keeping them healed, Leg Clubs and community nurses have the potential to save commissioners up to 80% of their wound care budget in comparison with conventional leg ulcer treatment. They save on direct and indirect travel costs, reduce the need for the duplication of equipment, simplify planning and administration and eliminate wasted home visits.

By virtue of their role, community nurses see the challenges and needs of their local community and are pivotal in making sure this insight is fed back to their local CCG. Some commissioners have recognised this and are using the Leg Club model to 'make every contact count'. Nurses have been involved in developing other services within Leg Clubs such as podiatry, diabetes and healthy-heart programmes, adapting the model to their locality.

Community nurses must engage with commissioners and help CCGs provide effective community services, recognising their own potential to improve services for patients.

Ellie Lindsay is the founder and president, Lindsay Leg Club Foundation