Crisis of Leg Ulcers in UK: Numbers of People with Leg Ulcers is Increasing; NHS failing to treat

Leg Ulcers on the Rise: Why the UK's Venous Care System is Failing
The number of people with an active leg ulcer in the United Kingdom is growing, yet access to treatment seems to be getting worse.
So, might Foam Sclerotherapy be the "miracle cure" or is it just a band-aid solution?
Earlier this week, I had a long and interesting conversation with Professor Bruce Campbell who is the President of the Venous Forum of the Royal Society of Medicine in the UK
We covered many topics, but the one that got me "going", was the appalling problem of leg ulcers.
It's PERSONAL - my Mother had a leg ulcer for over a year before she finally confided in me. But that another story...
The Growing Burden of Venous Disease
The UK is facing a silent crisis in venous care. The number of people with active leg ulcers is on the rise, yet access to treatment seems to be getting worse. This is a complex issue with multiple contributing factors, ranging from lack of awareness in primary care to limited resources and competing priorities in secondary care.
Bruce covered these in an editorial that he wrote with Dan Carradice
doi.org/10.113...
Primary Care: The Need for Early Recognition
Many GPs fail to recognise the early signs of venous skin change, leading to delayed referrals and missed opportunities for early intervention. Improved education and awareness in primary care are crucial to addressing this issue.
Secondary Care: Streamlining Pathways and Prioritizing Venous Disease
Once patients develop ulcers, seamless pathways from community nursing care to secondary care are essential for prompt and effective treatment. However, in many areas, these pathways are fragmented or nonexistent. Additionally, the predominance of arterial disease in vascular surgery training and practice often results in venous disease being relegated to second place.
The Role of Vascular Surgeons and the Need for Venous Leads
While vascular surgeons play a critical role in the treatment of venous disease, the competing demands of arterial disease often limit their capacity to address venous issues effectively. Each vascular unit should have a dedicated venous lead to champion the management of venous disease and ensure that it receives adequate attention and resources.
Expanding Treatment Options: The Potential of Foam Sclerotherapy
Ultrasound-guided foam sclerotherapy is a simple, cheap, and effective treatment for superficial venous reflux, the most common cause of venous leg ulcers. While its long-term efficacy may be debated, it offers a valuable option in a cost-strapped healthcare system where many patients currently receive no treatment at all.
The Role of Non-Vascular Surgeons: An Inevitable Evolution
The question of who should treat patients with venous disease is a contentious one. There are valid concerns about training, governance, and complications, but the reality is that more treatments will inevitably be administered by non-vascular surgeons in the future. This evolution should be carefully managed with attention to training and governance, but it also represents an opportunity to expand access to treatment and address the growing burden of venous disease.
The Venous Forum: A Continuing Discussion
The Venous Forum and other organisations play a crucial role in raising awareness, providing guidance, and facilitating discussion on the challenges of venous care. This is an ongoing conversation that requires continued attention and advocacy to ensure that patients with venous disease receive the timely and effective treatment they deserve.
Conclusion
The silent crisis of venous care in the UK demands urgent attention. It will require a multifaceted approach that includes improved education in primary care, streamlined pathways in secondary care, increased focus on venous disease within vascular surgery, and expanded treatment options through the careful evolution of non-vascular surgeon involvement. This is a complex challenge, but by working together and prioritising venous care, we can make a meaningful difference in the lives of countless patients affected by this debilitating condition.
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Disclaimer: This video is based on a conversation between Haroun Gajraj and Professor Bruce Campbell. The views and opinions expressed in the conversation are their own and do not necessarily reflect the official stance of the Venous Forum or any other organisation.