Claire Storry and Carol Brailsford
Community Staff Nurses,
East Lincolnshire PCT
Tel: 01507 478548
Email: Claire.storry@EastLincs-PCT.nhs.uk
Summary:
The ethos of the Lindsay Leg Club Model aims to work in partnership with club members to provide research based wound management in a non-clinical, social environment. Adopting a flexible drop in approach that encourages attendance for treatment, information and advice. Facilitating early diagnosis and education, promoting healing, increasing concordance and minimising reoccurrence through systematic monitoring and well leg checks.
Members are empowered to become stakeholders in their care promoting a sense of ownership and involvement. Social needs of isolated patients are addressed through mechanisms for social interaction, empathy and peer support, rebuilding self-esteem and self-respect by de-stigmatising their condition. (Lindsay 2004)
Abstract:
Our local area has one of the highest densities of over 60’s population so proportionally there is a higher number of leg problems and long term debilitating illnesses. This prompted us to change our practice in order to meet their needs. The Leg Club model changes our current local practice from leg ulcer treatments for existing wounds within a clinical environment to treatments, health promotion, education and on going care for people of all ages who are experiencing leg related problems, as well as those with existing wounds in a non-clinical environment.
The Leg Club encourages a unique partnership between nursing staff, club members and the local community by transferring the balance of power from a medical model of care to patient led care. This approach of members’ empowerment transfers responsibility and ownership of their own care. The model also addresses the holistic needs of isolated patients by creating a social and friendly setting at our local Community Hall.
The Lindsay Leg Club Foundation encouraged the Leg Club initiative. The change in practice has been fully supported by our Primary Care Trust. We have worked with existing patients, colleagues and organisations while analysing the need for change using Lewin’s Force Field analysis.
The reception to the Leg Club has been truly overwhelming by our current patients while transferring from a medical model to a social model of care. Our present community nursing team has a very positive approach to the change and can foresee the benefits for club members. As the Leg Club has charity status the members with fundraising and donations meet the running costs. The consultant vascular surgeon has also identified the need to hold domiciliary clinics within our Leg Club.
Although our Leg Club is still in its infancy not opening until December 2005, the attitude of our current patients in relation to their own health has changed significantly. The steering group, which consists of members, community leaders and volunteers, have already taken ownership of the club, making decisions about how they want the Leg Club to be run. Our input has been to present the Leg Club ethos to them and provide ongoing support and information.
Existing roles have changed to embrace the Leg Club ethos. Through implementing this radical approach to wound care delivery as a team we have experienced a steep learning curve, through the need for education but the importance of team building is paramount and greatly enhances workforce development, which gave us the opportunity to truly get to know the local community and their needs. Presently the Leg Club will cater for members registered with our local GP’s however we can see expansion in the future.
Research of existing Leg Clubs has demonstrated significant improvements in a range of ‘quality of life’ indicators such as healing rates, pain levels and patient moral for members attending Leg Clubs compared to those receiving traditional treatments. Our own data, at the present time, is limited due to the Leg Club not starting until the 2nd December 2005, but will be available in 2006.
The enthusiasm, involvement and support shown by our existing patients prior to the Leg Club launch on the 2nd of December 2005 has demonstrated a change in their attitude towards their leg ulcers already. Their commitment to fundraising and charitable donations has been phenomenal and they have already formed a network, supporting each other. Job satisfaction for the nursing team has also increased due to the positive attitude of the leg club members. This approach with the community concords with the recent government paper Creating a Patient-led NHS (DOH 2005).
The Leg Club provides treatments and support for a diversity of people who are experiencing leg related problems within our GP’s practice population. The traditional methods of treating leg ulcers will continue to be available should any people not wish to participate in the Leg Club.
The diversity of staff groups are met through ongoing support and training from the Leg Club Foundation. Initially the Leg Club will be staffed by a small proportion of the community nursing team, however, the remaining members of the team will be welcomed at the club should they wish to participate, but at no time will any team member be expected to work within the Leg Club.
Following our initial meeting with Ellie Lindsay the Leg Club founder we approached our management about opening the 1st Leg Club in Lincolnshire. With there support we sent fliers to all other district nursing teams within our locality following this with a presentation of the Leg Club ethos.
To assist ourselves with the set up we visited other existing Leg Clubs in other areas of the country. Although the Leg Club concept is new we have to ensure that our own local protocols and procedures are adhered too. To ensure all aspects were covered we had meeting with the tissue viability nurse specialist, the Consultant Vascular Surgeon, Infection Control Specialist and the Director of Provider Services for the Primary Care Trust.
The commitment, enthusiasm, motivation and support for the Leg Club have been overwhelming. Patients, the local community and all health professionals have embraced the ethos. We feel as health care professionals our commitment and motivation to the management of leg ulcers within our socially deprived area shows the energies, imagination, and innovation needed to drive positive change forward to benefit our community.
