Access to effective wound care is a vital component of health care, yet not all populations in England receive it equally. This blog highlights the urgent need for targeted health care interventions for vulnerable patients, including homeless people and those with substance misuse issues.

Wound care disparities

Recent studies reveal that vulnerable groups in England face notably poorer outcomes in wound management due to multiple barriers to accessing standard health care services.

For instance, according to Homeless Link, people experiencing homelessness are three times more likely to suffer from chronic wounds compared with the general population, a gap that poses both a health care challenge and a moral dilemma.

Additionally, the British Journal of Nursing reports that people with substance misuse issues often experience delayed healing and complications due to poor nutrition, compromised immune systems, and inconsistent access to care.

Challenges in care delivery

The primary challenge is the inaccessibility of tailored health care services that accommodate the unique lifestyles and needs of these groups.

Conventional health care settings often fail to provide the required flexibility or sensitivity, which discourages these populations from seeking necessary care.

The stigma associated with homelessness and substance misuse can result in discriminatory attitudes from health care providers, further alienating these individuals from receiving adequate care.

This systemic issue is compounded by the lack of comprehensive data on the specific needs of these populations, leading to gaps in service provision and policymaking.

Innovative strategies for change

Several strategic initiatives have been proposed to address these disparities:

• Mobile health clinics: Bringing health care services directly to the populations in need to reduce access barriers. These mobile units can travel to locations frequented by homeless people and those with substance misuse issues, providing on-the-spot wound care and follow-up services. Mobile clinics have been shown to increase health care access by up to 50 per cent in underserved populations, significantly improving health outcomes.
• Integrated Care Pathways: Developing holistic care models that involve various health care professionals to address the broad needs of these patients. The Care Quality Commission 2020/21 State of Care report describes the collaboration of general practitioners, nurses, social workers, and mental health professionals to provide comprehensive care plans that address both the physical and psychological needs of patients. Integrated care pathways not only streamline the treatment process but also ensure continuity of care, which is critical for chronic wound management.
• Education and training: Enhancing the competency of health care providers to deliver culturally sensitive and effective wound care. This involves training on the specific challenges faced by vulnerable populations, such as the impact of living conditions on wound healing and the importance of trauma-informed care.

By equipping health care providers with the necessary skills and knowledge, NHS Improvement shows the quality of care for these populations can be significantly improved. For instance, specialised training programmes have been associated with a 30 per cent increase in patient satisfaction and adherence to treatment plans.

Impact of strategic changes

Implementing these strategies not only promises to improve the direct outcomes for individuals with chronic wounds but also offers broader societal benefits by reducing hospital visits and associated health care costs.

For example, effective wound management can reduce the incidence of infections and other complications that often lead to hospital admissions.

A British Medical Journal study in 2021 found that integrated care models could reduce emergency department visits by up to 25%, translating to significant cost savings for the health care system.

Urgent action needed

The inequality in wound care is a glaring issue that needs immediate and concerted efforts to resolve.

By adopting innovative and inclusive health care strategies, we can ensure that all members of society have access to the care they need, regardless of their social circumstances.

Addressing these disparities requires a multi-faceted approach that includes policy changes, increased funding for targeted programmes, and ongoing education for health care providers.

Only through sustained and collective efforts can we hope to achieve true health care equity for vulnerable populations.

Share your thoughts

Let us know your thoughts and any experiences you have in addressing these health care challenges in the comments below. Together, we can push for changes that will bring about true health care equity.

Further reading and resources

For a practical application of these concepts, check out our newly funded Q Exchange project, which aims to provide equitable wound care to the most marginalised individuals in our community. Visit our Reducing Inequalities in Wound Care for Our Vulnerable Population page.

See the British Journal of Nursing article on wound care in hard-to-reach populations.

Visit the National Wound Care Strategy website.

Learn more from the Care Quality Commission 2020/21 State of Care Report.