Hard-to-heal wounds are challenging to manage and incur a cost burden to healthcare systems through extended treatment periods, resource use and patient quality of life. The aim of the service evaluation presented here was to determine the wound healing and health economic impact of using PICO™ Single Use Negative Pressure Wound Therapy (sNPWT) on hard-to-heal wounds at seven centres across Northern Ireland and the Republic of Ireland. Patients with clinically defined hard-to-heal wounds received PICO sNPWT, as per a clinician-endorsed PICO sNPWT hard-to-heal pathway (Dowsett et al, 2017). Wounds were assessed for their healing trajectory over a 12-week period. Of wounds included (n=36), 20 (55.6%) healed within the 12-week routine follow-up period. Wounds of <3 months’ duration reported a significantly higher healing rate compared to wounds with a duration of >3 months (p=0.0125). Dressing-change frequency significantly reduced during PICO sNPWT treatment compared to the standard dressing regime before the evaluation (p<0.001). Furthermore, dressing change frequency remained significantly reduced after PICO sNPWT treatment was introduced, when compared to the pre-pathway standard dressing regimen (p<0.001). Health economic modelling suggested a cost-saving of 21% (€12,001) for the Republic of Ireland, and 25% (£15,467) in Northern Ireland, by using the PICO sNPWT hard-toheal pathway compared to standard wound management.