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A recent economic analysis has reported a £8.3 billion cost to the NHS for wound management. This overwhelming cost has meant alternate wound management strategies are needed. One example is a Hospital @ Home (H@H) negative pressure wound therapy (NPWT) service, whereby patients are discharged from hospital with an open wound and traditional NPWT (tNPWT) and/or single-use (sNPWT) is provided in their own home. The aim of the service evaluation presented here, which was conducted from the H@H nurse base within Brighton General Hospital, was to highlight the clinical outcomes of utilising NPWT in a homecare setting, to assess changes in patient quality of life through a validated instrument, and to understand the anticipated cost savings to the NHS. Thirty-one patients, all of whom had received surgical intervention resulting in an open wound requiring NPWT and were receiving H@H NPWT, were included in the evaluation. A statistically significant reduction in wound dimentions and improvement in patient reported general quality of life was found. Overall, the delivery of this H@H NPWT service enables patients to return home, with ongoing wound management which results in wound closure. The service evaluation also enabled a cost saving analysis to be reported, suggesting that this locally implemented H@H service can reduce costs of approximately £5,256 per patient by utilising H@H NPWT compared to hospital inpatient managed NPWT.

The definition of incontinence is acknowledged as any involuntary loss of urine or the inability to control the bowels (International Continence Society [ICS], 2013). It is not a life-threatening condition, but has a significant and distressing effect on the physical, psychological and social quality of life of those affected (Lukacz et al, 2011). Isolation, anxiety, depression and embarrassment are commonly reported by people who have a bladder or bowel issue (Wan and Wang, 2014). Urinary incontinence is more common than breast cancer, heart disease or diabetes among older women (Sexton et al, 2011; Tannenbaum et al, 2013). Incontinence is not gender or age specific, it can affect people of all cultures at any point from childhood to old age and can have devastating implications for the individual and their family. Many people may fail to seek help with incontinence for years due to embarrassment and stigma.

Here, Davina Richardson, children’s specialist nurse, Bladder & Bowel UK, looks at the guidance available for school leaders, proprietors, governors, staff and practitioners to help them better support children and young people with bladder and bowel issues as they return to school.