Resources

Welcome to another issue of the JCN, which, as always, includes articles relevant to your day-to-day practice. I was particularly interested to read the editorial from the Queen’s Institute of Community Nursing on its new Faculty of Homeless and Inclusion Health, and would encourage you all to find out more and get involved. This focus on inclusion and equity is reinforced by Rebecca Bullingham’s important article on health equity, which explores the relationship between language, health equity and community nursing. The terminology we use matters, as it can influence how people are perceived, how they experience services and their access to care. Rebecca highlights the importance of looking beyond individual practice to consider how systems and services can change to reduce health inequalities and ensure that everyone can access care that meets their needs.

There is no need to rehearse the case for change in lower limb wound care. In the June issue of this journal, Rachael Lee, national programme manager for the Transforming Wound Care Programme, clearly set out both the need and the evidence (Lee, 2026). The clinical argument is compelling, the intervention is proven and the opportunity to improve outcomes for patients is clear. New data around the economic impact of addressing the wound care burden highlights there are fiscal benefits to addressing lower limb wound healing (Health Innovation Network, 2026).

In the UK, millions of people are not meeting their requirements for essential nutrients. The new report, Dietary deficits and future health and wellness fallouts, published by the Health and Food Supplements Information Service (HSIS, 2026; www.hsis. org), highlights a nation struggling with what experts describe as a ‘honeycomb’ of vitamin and mineral deficiencies – with potentially severe consequences for physical and mental wellbeing.

In an ever-racing world, time and attention have become the currency of the moment.

Just recently I spoke with a patient who told me that they felt so relieved to now fully understand their symptoms and have come to a joint decision with their specialist about a procedure. Six months ago, when the same procedure was suggested to her, she declined. Not because she disagreed or that she was being difficult. It was because no one had spent the time to really explain her symptoms and the rationale behind the suggested procedure. So, for the last six months, she continued on the merry-go-round of showing up at A&E whenever her symptoms flared up. Each time she would be sent away with a pack of antibiotics and little else. No discussion and definitely no literature in her own language. And so it becomes clear how the revolving door effect is perpetuated by the healthcare system itself.

As the number of people living with dementia continues to rise, finding simple and accessible ways to support wellbeing, connection and quality of life is increasingly important. New research into outdoor musical instruments in care settings suggests that combining music, play and access to the outdoors could offer valuable benefits for residents, families and care professionals.

Here we talk to Lexi Chambers, a former nurse and Army veteran, whose experience of illness has turned personal adversity into extraordinary achievements. After choosing to undergo below-knee amputation in 2019 as a result of complex regional pain syndrome (CRPS), Lexi went on to face further health challenges, including nerve issues and fibromyalgia, and more than 20 surgeries. Her experiences as both a nurse and patient have given her a unique perspective on healthcare, recovery and the importance of compassionate, person-centred care. Now a seven-time Guinness world record holder, with further records in the pipeline, she reflects on her nursing career, her experiences on the other side of healthcare, and what has driven her to achieve so much despite adversity.

As the NHS works towards its net zero commitments, reducing waste associated with single-use medical products has become an increasing priority. Dressing packs (procedure packs) are widely used across community healthcare to support safe and efficient clinical practice, yet little is known about how these products are used, disposed of and perceived by healthcare professionals from a sustainability perspective. This article describes a collaborative project between two NHS trusts and an industry partner that explored opportunities to reduce waste associated with dressing packs while maintaining clinical effectiveness and patient safety. Through a survey of district nurses, the project examined current practices relating to dressing pack selection, use and disposal, alongside attitudes towards sustainability and environmentally responsible product design. The findings identified opportunities to optimise pack contents, reduce unnecessary waste and improve awareness of sustainable waste management practices. The project also informed the development of targeted educational resources and sustainability awareness initiatives. This collaborative approach demonstrates how healthcare providers and industry can work together to support behaviour change, reduce environmental impact and contribute to the NHS net zero agenda without compromising standards of care.

Aim: Chronic lower limb ulceration is a significant clinical challenge, particularly when complicated by comorbidities, infection and failure of surgical intervention. This case study shows how specialist-led conservative management supported limb salvage, even when reconstructive surgery and amputation were being considered. Methods: A 57-year-old man with obesity, hypertension and a complex history of left lower limb trauma and soft tissue reconstruction was referred to a specialist lower limb therapy service following failure of a split-thickness skin graft. Occupational demands limited standard compression options. The patient had recurrent graft failure, local infection and progressive wound deterioration, with significant psychosocial distress. Specialist conservative management included structured wound bed preparation, use of high-level short-stretch compression, and an antimicrobial moisture balance dressing. Results: Intensified management resulted in progressive improvement. Following initiation of Suprasorb® X + PHMB, wound moisture balance improved, granulation tissue developed over previously exposed muscle and wound depth reduced. Although plastics review recommended complex free flap reconstruction, with a possibility of below-knee amputation, continued healing supported further conservative management. Approximately 98% epithelialisation was achieved, with healthy periwound skin and limb salvage considered a realistic outcome. Conclusion: Surgical failure is not necessarily the end of the healing pathway. Sustained specialist input, high-level compression therapy and antimicrobial moisture balance dressings can support healing in complex lower limb wounds and may help avoid amputation.

Venous leg ulcers (VLUs) are common and costly to both the healthcare system and patients. They form a significant part of the burden of wounds within the UK. Strong compression promptly applied will heal the VLU but treating the superficial venous reflux may lead to faster healing. Patients with a VLU should be considered for referral to vascular services for assessment and intervention of the underlying problem. Venous intervention is a low risk, minimally invasive procedure performed under local anaesthetic that should be suitable for most patients. However, some groups of patients require special consideration and may be deferred instead of referred. For these patients, it may be more appropriate to optimise conservative treatment.

This second paper in the series on the assessment and management of osteomyelitis associated with pressure ulcers focuses on diagnosis, management, and prevention within community and primary care practice. It outlines key diagnostic principles, emphasising that confirmation of osteomyelitis is typically achieved through multidisciplinary assessment rather than a single investigation, and that the primary role in community settings is to recognise, document, and escalate appropriately. Management approaches include antimicrobial therapy, surgical considerations, pressure redistribution, and optimisation of health and wellbeing. The paper also highlights antimicrobial stewardship, the importance of person-centred goal setting, and the role of palliative wound care in individuals with advanced frailty or limited healing potential. It concludes with a call for action, advocating improved multidisciplinary collaboration, greater consistency in clinical pathways, and strengthened data capture to reduce variation and support safer, more effective care.