NHS trusts could face financial penalties if they fail to halve the number of pressure ulcers in their organisation during the 2013-14, under new rules from the Department of Health.
Hospitals and community services already measure incidences of pressure ulcers using the NHS Patient Safety Thermometer which also collects data on falls, urinary infections in patients with catheters and treatment for venous thromboembolism.
During 2012-13 trusts have lost income under contractual penalties if they have not collected and reported full data from the system. From April, trusts which have not been collecting data consistently will continue to face a national financial penalty of up to 0.125 per cent of their total income − worth £375,000 for a £300m trust.
However, trusts which are already collecting comprehensive data will be required to agree a target to reduce harm to patients. New guidance from the NHS Information Centre, backed by the DH, is recommending organisations are challenged to cut grade 2 to 4 pressure ulcers by a minimum of half in order to receive full payment.
This would also put 0.125 per cent of income at risk.
Latest data from the thermometer shows 6.6 per cent of patients suffered a pressure ulcer between April and July 2012, the biggest single cause of harm to patients whilst in NHS care. Just 1.2 per cent of patients suffered harm due to a fall and 4.7 per cent from a new urinary infection.
Data from the safety thermometer pilot work demonstrated that an average reduction in pressure ulcer prevalence of 42 per cent was possible through correct equipment, intentional rounding and ensuring adequate hydration and nutrition.
Senior lecturer in tissue viability at Hertfordshire University Julie Vuolo said she hoped a target would bring extra attention and resources to reducing pressure ulcers and stop them being “seen as a nursing problem”
She said it was positive that trusts were being asked to improve upon their own performance rather than comply with a national target however warned that zero harm, although a worthy ambition, might not be possible.
She added: “The problem becomes when the penalty isn’t just financial; it becomes about finger pointing at staff… I worry about the burden on nurse specialists, who is going to be responsible when the target is not met?”