Today is STOP Pressure Ulcer Day to raise awareness of pressure ulcers, which are largely preventable lesions many people suffer as a result of periods of prolonged pressure causing damage to the skin and underlying tissues. The STOP the Pressure campaign is run by NHS England and NHS Improvement with a view to improving standards of care to reduce the number of people who suffer this debilitating and painful problem.
A pressure ulcer (also known as a pressure sore or bedsore) is damage to the skin and underlying tissue caused by prolonged pressure on the skin. Pressure Ulcers are graded in 4 categories:
Stage 1 - part of the skin becomes discoloured
Stage 2 – develops into an open wound or blister
Stage 3 - a deep wound that reaches the deeper layers of the skin
Stage 4 - a very deep wound that may reach the muscle and bone
Pressure Ulcers can be extremely painful and may result in infection, amputation and sometimes death.
Whilst many pressure ulcers are suffered by elderly or very unwell patients, with reduced mobility, many other groups of patients are vulnerable to this complication, such as babies in the neonatal unit who can suffer damage to the delicate skin on their face due to placement of breathing tubes; women in the maternity unit who spend prolonged periods of time on a bed under epidural anaesthesia; and patients with diabetes who are particularly vulnerable as their condition can lead to neuropathy where they don’t notice the uncomfortable sensation of prolonged pressure or misfitting shoes etc.
There are a number of tools health professionals can use to assess the risk of pressure damage such as the Braden scale, the Waterlow score or the Norton risk-assessment scale. Where there is an identifiable risk of pressure damage, steps can be put in place to reduce the risk by a combination of a number of factors such as routine repositioning or movement; pressure relieving mattresses and cushions; offloading devices; barrier creams and continence aids to protect against moisture and soiling; and improved nutrition and hydration.
NICE (the National Institute of Clinical Excellence) has issued guidance to healthcare professionals on the prevention of pressure ulcers, which can be viewed here
Despite the resources available to minimise the risk of pressure damage, it is estimated that 1,300 pressure ulcers are reported within the NHS each month. Pressure ulcers are often considered to be “never events” i.e. a serious incident which is wholly preventable as a result of widespread protective barriers. In 2018, NHS Improvement decided not to include pressure ulcers in the list of NHS “never events” as there is a degree of subjectivity as to whether some incidents of skin breakdown are due to pressure, however, in the majority of cases appropriate risk identification and pressure area management will significantly reduce the risk of pressure damage. For this reason, when patients develop pressure damage whilst under the care of a hospital or nursing home, this often leads to the patient having a claim in negligence.
NHS Resolution have confirmed that in the year 2018/2019, 331 successful claims were brought against the NHS arising from pressure damage. Sadly 8 of the claimant’s suffered such severe damage they had to undergo an amputation. The total cost to the NHS of those claims was over £26 million.
At Burnetts, we have experience of assisting client’s who have been unfortunate enough to suffer a pressure ulcer whilst under the care of a hospital or care home. We have specialist medical negligence solicitors, who are accredited by The Law Society and AvMA, who can investigate your claim and help secure compensation. Our solicitors have access to specialist medical and nursing experts and barristers who can advise in your case and will aim to obtain compensation for you as quickly as possible.
If you would like to speak to someone within our team to discuss whether you may have a clinical negligence claim then please contact our offices on 01228 552222.