Neil Kennett-Brown, Programme Director of System Sustainability for South East London Integrated Care Board, introduces the three-year programme for improving lower limb wound care pathways across south east London.
The South East London Integrated Care Board (SEL ICB) and the Health Innovation Network (HIN) South London have partnered to transform lower limb wound care across all six boroughs - Bexley, Bromley, Greenwich, Lambeth, Lewisham and Southwark – to deliver transformation of the current lower limb wound care pathways according to/using the National Wound Care Strategy Programme (NWCSP) recommendations.
Nationally, the healthcare cost of leg ulcers in England was estimated at £3.1 billion per year in 2019, based on approximately 739,000 leg ulcers and without intervention, the number of leg ulcers is expected to rise. Projections suggest leg ulcer prevalence could increase by around 4% annually, exceeding one million cases by 2036.
There is strong national evidence that lower limb wound care can be significantly improved. The National Wound Care Strategy Programme (NWCSP) developed evidence-based recommendations and tested them across NHS implementation sites. An independent 2024 evaluation showed impressive results:
52% of venous leg ulcers healed within 12 weeks.
84% of all lower limb wounds healed within a year, compared with a national baseline of 37% previously.
Recurrence rates fell to 14%, far below previous estimates.
The programme demonstrated exceptional value for money, with a benefit–cost ratio of 27.6.
Why lower limb wound care needs to change
Across south east London, up to 6,500 people are living each year with painful, slow healing chronic lower leg wounds. The estimated prevalence of venous leg ulcers in the UK is between 0.1–0.3%, increasing with age. These lower limb wounds not only impact mobility, independence, and overall wellbeing, but also place a considerable financial strain on the NHS. This is why transforming lower limb wound care is so important.
Chronic lower limb wounds account for at least 42% of all wounds in the UK, making them one of the most common and costly long-term conditions seen in the community. For south east London, improving care pathways offers an opportunity not only to improve outcomes for patients and speed up their healing, but also to free up clinical time and resources.
What is the change we are making?
Our shared aim is for consistent, evidence-based high quality care to be available for every patient. We aim for it to be delivered close to patients' homes, and supported by a skilled workforce with modern digital tools.
This is a three-year programme that brings together patients, carers, and clinicians across GP practices, community nursing teams, specialist clinics, care homes, and podiatry.
This programme of work also aligns with the Neighbourhood Health agenda as we aim to support efforts to: reduce health inequalities, empower local communities, and lower the region’s carbon footprint through more efficient and preventative models of care.
How we will achieve this - the three pillars of transformation
People
Building capability and confidence.
We will strengthen training and support staff across primary care, community services, and specialist teams using the NWCSP Wound Care Core Capabilities Framework. By doing so, we aim to ensure the right skills are in the right places, and that staff are confident with assessment, compression, and prevention. We will provide patients with the opportunity for supported self-management where appropriate.
Processes
Embedding the evidence-based pathway.
We are implementing and aligning local pathways with the NWCSP Best Practice Leg Ulcer Bundle. Getting the assessment and treatment (and/or compression) right is critical to better outcomes.
Technology and data
Using digital tools to support care.
Digital lower limb wound management systems help clinicians capture consistent images and measurements, spot deterioration sooner, and share information across teams. In some community providers in south London, a digital solution has already proved successful in reduced variation, improved monitoring, and saved clinical time, contributing to faster healing and more proactive care.
The impact of delivering the right care to patients with lower limb wounds
For patients and their families, this programme is about restoring confidence, independence, and quality of life. Faster, evidence-based treatment means people can get back to the things that matter to them sooner: work, social connections, caring responsibilities, and day-to-day activities. Many patients describe years of frustration, pain, and feeling dismissed or stuck in a cycle. This new approach is designed to break that cycle by ensuring early assessment, strong compression (where appropriate) and regular review as standard care.
One patient, who had lived with leg ulcers for a decade and struggled with severe depression and anxiety, healed within just six weeks of starting compression therapy, going from rarely leaving their house to seeing friends and even dancing. They shared with their clinical team that their life has “changed completely”.
Another, a restaurant owner whose leg ulcer was disrupting her ability to work, saw complete healing in ten weeks and described feeling “overwhelmed with happiness” by the consistent care she received.
A third patient, who believed he would never have a “normal leg again” after a recurrent lower limb wound lasting three years, healed within eight weeks. These are not isolated stories; they are glimpses of what becomes possible when best practice is applied consistently and early.
By improving consistency in care and making information easier to access, we aim to reduce the emotional, physical, and logistical burden that patients and carers are faced with. Digital tools will allow clinicians to monitor lower limb wounds more effectively, meaning fewer avoidable appointments and clearer communication about progress.
Above all, this programme is designed to offer every patient the same chance of lower limb wound healing and long-term wellbeing, no matter where they live in south east London.
Get involved
If you’re a healthcare professional in south east London providing care for people with lower limb wounds, we’d love for you to be part of this work.
Patients and carers are also encouraged to contribute their insights to shape lower limb wound care services that reflect local needs.
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