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Sunday, June 26, 2022

Solution to chronic wounds bleedingly obvious: comprehensive reforms, but who will deliver?

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They are painful, unsightly and very rarely a topic of conversation, but this election season, Wounds Australia is calling for greater awareness and action on a condition that chronically affects more 420,000 Australians.

Wounds, often seen as a temporary inconvenience or a secondary condition, must be given attention as a serious condition in their own right, Wounds Australia CEO Helen Jentz says.

“They result in amputation and, in absolute extremity, can result in death,” Jentz tells Aged Care News.

“They impact upon a person’s mental health; they impact upon their ability to work, to socialise.

“I was chatting to a colleague the other day, who had a wound patient who didn’t go to her own daughter’s wedding.

“She was so embarrassed about the wound she had on her leg — these are the real world stories.”

Helen Jentz, CEO of Wounds Australia, says that more must be done to reduce the prevalence of chronic wounds, which affect 420,000 Australians annually.

A wound persisting for more than four weeks marks the clinical definition of a ‘chronic wound’, but Jentz says thousand of Australians endure the condition for much longer.

“Members of my board who are clinicians, they have some patients who have lived with chronic wounds for decades because they haven’t been able to get the help and support they need to get these wounds healed.

When parties and candidates develop their policies, and when people cast their vote, we want them all to understand the seriousness of Australia’s hidden epidemic of chronic wounds.

Helen Jentz

“And I think it’s only going to get worse if we don’t take really proactive and aggressive action now because we have an ageing population — and look what’s going on in the aged care industry at the moment.”

‘No F’s given’ – political parties’ wound-care policies rated

Wounds Australia has released a range of scorecards which rate the health policy proposals of the major parties and key independents as they relate to wound care.

“When parties and candidates develop their policies, and when people cast their vote, we want them all to understand the seriousness of Australia’s hidden epidemic of chronic wounds,” Jentz says.

The Labor Party received an A, the Greens a B+ and the Coalition a B, with these scorecards and supporting information distributed to more than 18,000 Wounds Australia members and supporters across the country.

“This is the first time Wounds Australia has surveyed and ‘scored’ candidates and parties.

“Given the high level of engagement by candidates and strong interest from our members and supporters, we will continue the approach,” Jentz says.

Wounds Australia has released a set of scorecards to inform voters on the extent to which prominent political parties’ and independent candidates’ policies will enhance wound care.

The Labor Party came out on top due to a recent announcement to focus on chronic conditions in their proposed Strengthening Medicare Fund, and their commitment to 24/7 nursing in residential aged care.

The Coalition has committed $2.1 million specifically to consider the development of a wound care consumable scheme, but their score lagged due to unaddressed recommendations from the aged care royal commission.

The solution to chronic wounds is bleedingly obvious. Voting to prevent and heal wounds should be just as obvious.

Wounds Australia CEO, Helen Jentz

“As the Report Card ‘scores’ indicate, there are strong foundations for positive reforms and to deliver enhanced policies and programs in the next term of parliament,” Jentz says.  

“[But] Wounds Australia’s frustration is that we can’t seem to get a truly national approach to addressing this.

“The solution to chronic wounds is bleedingly obvious. Voting to prevent and heal wounds should be just as obvious.”

Reforms must embed importance of wound-care

Whichever party wins the election, a commitment to comprehensive reforms is needed, including strengthened wound-care education for healthcare professionals and a new, targeted Medicare Benefits Scheme (MBS) at the GP level.

While Medicare does cover consultations with GPs, Jantz says that there is no item that covers a treatment plan for wounds.

What we have been strongly advocating to all political parties is the establishment of a wounds consumable scheme, particularly targeted at the most vulnerable.

Helen Gantz

“There’s no item number that allows a GP to say “OK, I’m going to diagnose this wound, I’m going to put together a treatment plan and the ultimate goal is to heal,” Jentz says.

“Say your grandmother has a bit of a fall, she gets a skin tear and she goes to her GP, it would be very rare that the GP would have specific skills in wound diagnosis and the creation of a treatment plan with a view of healing.

“What would usually happen is that the GP would look at that and say, ‘OK, what I’m going to do is, I’m going to hand you over to the practice nurse, and they’re going to put a dressing on it’.

“So they’ll use whatever consumables they have available to them, and those consumables may not actually be what that particular wound needs to be able to heal in the shortest amount of time possible.”

Those with chronic wounds largely bear the cost of replacing dressings, and Wounds Australia estimates the average out-of-pocket costs for wound patients to be $4000 per year.

“What we have been strongly advocating to all political parties is the establishment of a wounds consumable scheme, particularly targeted at the most vulnerable,” Jentz says.

“So that would be a scheme similar to other schemes that the government already has in place — for example, the National Diabetes Services Scheme (NDSS).

If you’re not educating the people coming out of universities with the knowledge and the skills that they need, then what hope do we have of working towards healing these chronic wounds?

Helen Jantz

The NDSS is a federal government-funded scheme that provides free or partially subsidised access to a range of diabetes-related products, distributed by select, registered pharmacies across the country.

“Similarly, this would be a National Wound Services Scheme that provides [consumables for] patients who are at high risk,” Jantz says.

Astonishingly, Jentz notes that medical and nursing degrees do not currently include mandatory, rigorous wound care training.

“If you’re not educating the people coming out of universities with the knowledge and the skills that they need, then what hope do we have of working towards healing these chronic wounds?”

“The training and your skills development, particularly at a general practice level, has not been focused on wounds.

With pressure sores estimated to affect up to 43 per cent of aged care residents, Jentz says training must also be provided to support aged care workers in identifying and managing these wounds in their everyday practice.

“… Wounds Australia is really focused on helping workers within aged care to be able to get the necessary skills, at least to be able to identify, assess, and to refer to clinicians in treating and managing these wounds for these vulnerable people.”

Wounds Australia is the national peak body for wound prevention, diagnosis, treatment and healing.

To access the full political scorecards, and to learn more about Wounds Australia’s objectives, follow this link.

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