Summary

Hidradenitis suppurativa (HS) is a dermatological disease affecting 1% of the population. It is severely misdiagnosed and underdiagnosed, leading to sustained suffering and mismanagement. There is a lack of effective provisions in terms of wound and exudate management, which can begin in the primary care setting. Alison Schofield has been travelling across the UK, educating nurses and doctors about HS and effective wound care for HS, plus the impact this can have on the patient’s wellbeing and overall quality of life.

Method

Patients endure years of misdiagnosis and ill treatment, while there is a serious requirement for effective wound care management. This has implications around cost to the NHS, the patients themselves and society in general. The huge unmet clinical need had been overlooked for too long. Goal one was clinical awareness. This was achieved through the Journal of Community Nursing (JCN) and an in-person education day, as well as multiple publications on the subject, including a consensus statement in 2022. Goal two was primary care education. Multiple webinars were conducted for primary care clinicians, GP practice nurses, plus an eLearning module that was CDP-accredited. Goal three was patient support. This was achieved through engagement with several patient groups, as well as provision of clinical information to assist in the diagnosis and treatment of HS. There was also participation in patient group meetings and events, implementation of various initiatives since 2020, plus evaluation of pre- and post-module knowledge, with most participants reporting that their knowledge on the subject had increased and that they were able to recognise, diagnose and treat appropriately.

Results

The clinic at Salford Royal is now conducting wound assessments and provision of care for its HS patients. Awareness was raised among tissue viability specialists to improve recognition and care in the tissue viability setting. Case studies demonstrated improvement in patient outcomes, including quality of life, plus cost savings to the NHS as a result of the reduction in clinical time spent with patients. The British Dermatological Nursing Group consensus statement has laid the foundation for improved care pathways within the NHS for HS patients. Patient testimonials demonstrate multiple benefits to patients, their families and society.

Sustainability and Spread

Since 2020, the HS awareness and wound care campaign has been disseminated through a variety of media and in-person events, including 25 in-person JCN events (reaching over 5,000 nurses), plus multiple webinars and online live events reaching GPs, practice nurses, dermatology nurses and other primary and community care clinicians. Multiple patient-facing events have provided information and advice to patient groups. In addition, multiple peer-reviewed publications have been disseminated on HS and HS wound care, along with an eLearning module with CDP accreditation.