Better Care

BCHC commitment to quality care plays part in pressure ulcer reduction

Moseley Hall Hospital patient and nurse
Commitment to the key principles of high quality care has reduced pressure ulcers.

High quality care provided by BCHC staff has played a significant part in reducing new pressure ulcers by more than a third.

The dedicated efforts of healthcare colleagues across the Midlands and East of England has seen the proportion of patients with new grade 2, 3 or 4 pressure ulcers reduced by 36 per cent in the last six months.

The ambition to eliminate grade 3 and 4 avoidable pressure ulcers is one of three care quality priorities for BCHC (see notes), which has this year implemented an intensive programme of innovation and improvement as part of a wider focus on patient safety.

The Trust has worked closely with the Strategic Health Authority (NHS Midlands and East) as part of the Stop The Pressure! campaign and to share best practice across the health service.

BCHC is working to meet particular challenges in achieving this ambition as the majority of our services are delivered to patients in their own homes.

So, as well as improving their own practice in prescribing care to prevent pressure ulcers, our community and district nurses have also been working with patients, families and social care staff to use these prevention plans on a day-to-day basis. This includes education and advice as well as providing prevention equipment.

Some of the initiatives we have developed in this campaign include information materials for patients, carers and social carers including the Think SSKIN campaign, which helps patients manage their risk of developing a pressure ulcer and advice on how to alert nurses to early signs of skin damage.

The improvements seen in results measured using a Safety Thermometer are now being built on to further reduce the incidence of pressure ulcers and to sustain the results.

Director of nursing and therapies Beverly Ingram welcomed the news.

“The elimination of avoidable pressure ulcers is one of our three clinical priorities and the delivery of harm-free care has been a focus for the Board and our staff,” she said.

“These results are an encouraging start to our journey and show that the changes in practice our staff have put in place are helping to keep patients safe.

"We will continue to work with patients and their carers to raise awareness of the simple steps that can be taken to prevent pressure ulcers and how to contact us if they see early signs of skin damage.”

click here to find out how to 'Think SSKIN'

NHS Midlands and East’s Nurse Director Ruth May said: “This is a fantastic success story for patients, which is down to the dedication of frontline staff who have supported our ambition to eliminate avoidable pressure ulcers.

"It is particularly pleasing to see that over the past six months, numbers of the worst pressure ulcers – grade 4 – have halved.

“Pressure ulcers are a key indication of the quality of nursing care, and almost all of them are avoidable. I therefore view each and every avoidable pressure ulcer as unacceptable.”

“Although it’s vital for care staff to know how to prevent and treat pressure ulcers, the public can play their part too.

"We believe most people don’t realise that they may be at risk from getting a pressure ulcer, and don’t know how to prevent them. We want to change that.”

According to new data, on a single day in October 2012 over 400 fewer patients had a new pressure ulcer compared to figures recorded on a single day six months earlier.

Since April 2012, the number of patients with pressure ulcers has been counted on a single day each month in all types of NHS organisations. In the Midlands and East of England, it was reported that 574 patients (1.09%) had a new grade 2, 3 or 4 pressure ulcer out of 52,570 patients checked in October 2012.

Pressure ulcers cause long-term pain and distress. They start as damage on the skin or in the underlying tissue that can lead to an open wound. This is caused by pressure and shear on bony areas eg. the tail bone , heel, hip, elbow, ankle, shoulder, and the back of the head. The vast majority - around 95 per cent - of pressure ulcers are preventable.


  • Birmingham Community Healthcare's care quality priorities are to eliminate harm from pressure ulcers, catheter-acquired urinary tract infections, blood clots and falls; to improve nutrition and hydration and to increase the number of health visitors citywide.

  • Any member of the public who thinks they might have a pressure ulcer is urged to check with a healthcare professional, or call NHS Direct on 0845 46 47

  • To prevent and treat pressure ulcers, staff are asked to follow five simple steps of good quality care

  • More information about the Stop the Pressure campaign is available at

  • One of NHS Midlands and East's five ambitions is to eliminate avoidable grade 2, 3 and 4 pressure ulcers by December 2012.
  • Click here for regional pressure ulcer prevalence data, including each organisation in NHS Midlands and East:

  • For the definition of pressure ulcer grades, see the grading chart.