Skip to main content

Improving the health and wellbeing of patients with cellulitis

 

Introduction

Cellulitis, a bacterial skin infection, can lead to emergency admissions and sepsis if not promptly treated. Hospital admissions and GP events for cellulitis are rising, with 1.7% of emergency admissions in 2021-2022 attributed to cellulitis.

In Wales, cellulitis causes over 32,000 bed-days and 200,000 GP events annually, costing over £28 million. Enhancing care quality through evidence-based, patient-centred approaches and reducing waste and harm is crucial. The aim was to reduce cellulitis recurrence by 10% annually among 7,000 NHS Wales patients through education and effective treatment.

Methods

  • Identified need for improvement and planned change implementation.
  • Communicated with key stakeholders.
  • Focused on collecting reliable, evidence-based data for monitoring change.
  • Created three posts for National Cellulitis Improvement Programme (NCIP).

Goals:

  • Early identification and correct assessment of cellulitis patients.
  • Evidence-based treatment and equitable service delivery.
  • Efficient resource use and capturing patient values through  Patient Reported Outcome Measures (PROMS) and Patient Reported Experience Measures (PREMS).
  • Acknowledge and respect cultural and diversity needs.
  • Provide evidence-based education.

Aims:

  • Reduce repeated cellulitis incidence.
  • Decrease NHS costs of cellulitis recurrence.
  • Support education in Primary and Secondary Care.
  • Develop a cellulitis PROM.

Outcomes

  • Since April 2020, 28,000 individuals received a leaflet to reduce cellulitis risk and nearly 7,000 completed NCIP
  • PROMs indicate significant improvements in outcomes and quality of life.
  • NCIP reduced recurrent cellulitis episodes from 5,337 to 163, admissions from 2,955 to 31, and length of stay from 22,870 days to 164 days, saving over £15 million.
  • Every admitted cellulitis patient receives educational materials and clinical consultation options.
  • Initial goal to reduce recurrence rates by 10% greatly exceeded.
  • NCIP conducted 230 educational sessions, training 1,500 HCPs in Wales about cellulitis.

Learnings

  • Launching across all health boards was challenging due to varied governance.
  • Clear SOPs and Benefit Profiles were crucial.
  • Dedicated reports to Execs accelerated NCIP into Primary Care.
  • Data, especially PROMs, was essential to demonstrate value.
  • Should have considered a national digital programme for data capture.

What next?

  • NCIP integrated into six health boards; Powys set to implement Primary Care aspect soon.
  • Collaboration with GPs and Antimicrobial Pharmacists to include patients with multiple antibiotic prescriptions or long-term prophylactic antibiotics.
  • Wales sets a global precedent in cellulitis care with a replicable NCIP model.