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Fittleworth Medical Limited: a unique service supporting nurses in the community

31st October 2013

Fittleworth is a unique, independent home delivery service for Ostomy, Urology and Wound Care appliances, with a well-established ethos of providing a discreet service to ensure that every customer receives personal attention. The company is not tied to any manufacturer and can supply any appliance that is available on prescription, thus giving patients and nurses the opportunity to choose and obtain the most appropriate appliance to their needs.

A look inside the sample area at Rustington Care Centre.

History

In 1984, Jaqueline and Alan Seymour founded the company from their garage in the village of Fittleworth, West Sussex to supply stoma appliances to patients. From the outset, customers’ needs were foremost — an ethos the company has always maintained. At that time, stoma flanges were neither cut to size nor customised, and so they decided to pre-cut each pouch before delivery, thereby providing a truly personal service, which was also mirrored in their prompt, discreet, and local delivery service.

As a result of rapid growth, the company had to move several times to larger premises, before finally settling in the state-of-the-art Care Centre in Rustington, with a head office in Littlehampton. 

Rustington Care Centre.

Over the years, the company has acquired additional dispensing licences and today has over 30 Care Centres throughout the UK from Edinburgh to Plymouth. The local Care Centres are pivotal to the personal service that Fittleworth can offer, in that they have all the benefits of being part of a national organisation (flexibility and appliance availability), but with local drivers who know the area, their customers, and so can offer a more bespoke delivery service.

Wound Care Today spoke with one driver, who has been with Fittleworth for 16 years, and asked him what made the value-added service unique. He maintains it is the personal touch and the trust that is built up with customers from the regular, face-to-face contact over the years. During a normal working day he will visit around 25–30 customers, including one 85-year-old woman who always has a ‘cuppa’ waiting for him. The general feeling is one of satisfaction from both the customers and staff — as this driver said, ‘one of the most enjoyable aspects of the job is going home everyday feeling like I have made a difference’.  

Seamless service

Fittleworth takes a unique approach to service delivery, which is kick-started from the moment an order is placed through to delivery to the customer, with friendly staff tasked with ensuring that they take the time to understand the customer’s needs. As a leading National Dispensing Appliance Contractor (DAC) of Medical Appliances, Fittleworth can also support the NHS by offering a repeat prescription dispensing service throughout the UK.

Care is taken to check to make sure every delivery is right.

In addition to dispensing appliances free to customers, Fittleworth also have a nursing team offering specialised support and expertise for people with bladder and ostomy issues to help improve their quality of life. The range of nursing services include:

  • Stoma care advice and assessment
  • Bladder retraining programmes
  • Male and female ISC/ISD
  • Assessment for sheaths and body worn appliances
  • Advice on appliances when issues arise
  • Educational support

Unique dispensing service into the community

With nurse prescribing becoming widespread — there are more than 50,000 non-medical prescribers, which includes 30,000 healthcare professionals who work in the community prescribing from a restricted formulary (Culley, 2010; Courtenay, 2008) — it is crucial that these prescribers have easy access to the items they need to carry out their day-to-day clinical tasks. Patients view nurse prescribers as being more patient-centred, a key aspect of today’s NHS and a principle of nursing practice (Manley et al, 2011; Journal of Community Nursing, 2013), as they have the listening and communication skills needed to draw patients in to understand their condition and treatment which, in turn, helps patients to manage long-term conditions and self-care (Courtenay et al, 2011).

The majority of Wound Care is managed in the community (Moore and Cowman, 2005; Drew, 2007), with community nurses spending up to 66% of their time on its provision as, on average, patients receive 2.4 dressing changes per week (Clarke-Moloney et al, 2006; 2008; O’Keefe, 2006). There is no doubt that having a wound can negatively impact on quality of life (Persoon et al, 2004), and thus nurses in the community need to have the appropriate dressings at their disposal to provide best practice in wound care and promote patient wellbeing, which is also considered an essential outcome of care in today’s NHS (Department of Health [DH], 2011; International Consensus, 2012). The expected rise in those aged 65 or over is inevitably going to increase community nurses’ caseloads even further (for example, it is estimated that 3–5% of those over 65 years will suffer from a leg ulcer, Mekkes et al, 2003). Thus, a service that ensures that wound care appliances are readily available in patients’ homes for nurse visits will put an end to wasted nurse hours getting prescriptions dispensed, or visiting patients who have been unable to get the items needed in time for the visit, as seen in the case presented below. 

Case Report — Wound Care Delivery

In the past, the district nursing team in Leamington had an agreement with a local community pharmacy group to stock, dispense and deliver the wound care items needed to treat patients. However, there were issues with the supply in that they had to wait many days for the stock to arrive, or had to visit numerous pharmacies to get the prescriptions dispensed.

After discussion with Fittleworth, Leamington community nursing team embarked on a pilot scheme, which involved Fittleworth dispensing and delivering all the wound care appliances they required, at the lowest unit of measure on the NHS Drug Tariff. A fax-ordering facility was instigated to help improve formulary control, reduce wastage and speed up the delivery process. All appliances were stocked and dispensed from the local Fittleworth Care Centre, which meant that the driver could ensure anything needed was in patients’ homes before the nurse visited, with 90% of orders being delivered in 24 hours and 100% within 48 hours. A dedicated account manager and customer service team were also put in place to deal with any problems and to ensure formulary adherence.

This system quickly resulted in an improved service for the patients in that they no longer needed to stockpile dressings at home, or rely on family/friends or nurses to collect their prescriptions for them. In turn, the nurses found that they now had more time to see patients in that they no longer needed to chase down prescriptions. Furthermore, they also had access to the right wound dressings at the right time.

Throughout the entire process, Fittleworth kept accurate and up-to-date management reports, which showed a clear view of usage, spend and ordering patterns.

To be totally honest, the service that Fittleworth already provides, has everything covered for my patients. Your customer service team go above and beyond what I would expect from them, to ensure all my patients home delivery needs are met. It always surprises me when I speak with them that they remember my nurse number, they deal with so many nurses! I am very happy with both the level of service Fittleworth provides to my patients, and to me and my colleagues.

District Nurse

Conclusion

Nurses in the community need to feel supported by having timely and effective access to the appliances required to fulfil their prescribing role. This, in turn, helps to maintain patient confidence and plays a part in improving patient quality of life.

Fittleworth provide a unique, tailored service on an individual and local level for Ostomy, Urology and Wound Care appliances and ensure that items are delivered where and when needed, thus facilitating clinical and cost-effective care.

To learn more about Fittleworth, visit: www.fittleworth.com/

FaceBook: https://www.facebook.com/FittleworthMedicalLtd

Twitter: @FitMed1 https://twitter.com/FitMed1

LinkedIn: Fittleworth Medical Limited http://www.linkedin.com/company/2987348?trk=tyah&trkInfo=tas%3Afittlewo%2Cidx%3A1-2-2

References

Clarke-Moloney M, Keane N, Kavanagh E (2006) An exploration of current leg ulcer management practices in an Irish community setting. J Wound Care 15(9): 407–10

Clarke-Moloney M, Keane N, Kavanagh E (2008) Changes in leg ulcer management practice following training in an Irish Community Setting. J Wound Care 17(3): 116–21

Courtenay M (2008) Nurse prescribing, policy, practice and evidence base. Br J Community Nurs 13(12): 563–6

Courtenay M, et al (2011) Patients views on nurse prescribing: effects on care, concordance and medicine taking. Br J Dermatol 164: 396–401

Culley F (2010) Fitness to Prescribe. Lecturer. Association of Nurse Prescribing 12th Annual Conference: Planning Prescribing into 2012. London: Sadler’s Wells Theatre, London, 25 November 2010

Department of Health (2011) Innovation, Health and Wealth: accelerating adoption and diffusion in the NHS. DH, London. Available online at: http://ww.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_134597.pdf

Drew P, Posnett J, Rusling L (2007) The cost of wound care for a local population in England. Int Wound J 4(2): 149–55

International Consensus. Optimising wellbeing in people living with a wound. An expert working group review. London: Wounds International, 2012. Available online at: http://www. woundsinternational.com

Journal of Community Nursing (2013) Celtic tigers are earning their stripes. J Community Nurs 27(24): 8–9

Manley K, et al (2011) Person-centred care: Principle of Nursing Practice. Nurs Standard 25(31): 35–7

Mekkes JR, Loots MA, van der Wal AC, Bos JD (2003) Causes, investigation and treatment of leg ulceration. Br J Dermatol 148 (3): 388–401

Moore Z, Cowman S (2005) The need for EU standards in wound care: an Irish survey. Wounds UK 1: 20–8

O’Keefe M (2006) Evaluation of a community-based wound care programme in an urban area. Poster presented at: Innovation Education Implemetation. EWMA Conference, Prague, Checz Republic: 127

Persoon A, Heinen M, van der Vleuten C, et al (2004) Leg ulcers: a review of their impact on daily life. J Clin Nurs 13: 341–54

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