Regular readers may be anticipating some more thoughts on evidence in wound care and tissue viability, or on the case for silver dressings. However, more urgent matters demand consideration. First, the plight of our elderly population in care: much has already been written on this topic in other journals and in the national press. Very little of this has touched upon matters of tissue viability. I am concerned by the prospect of the plans to increase the role and responsibility of the general practitioner (GP) in the NHS. With specific focus on our collective interests, the ‘failings’ of the current system do not inspire any confidence that much more of the same will bring improvements. The ‘failings’ to which I refer are the standard of care of patients of all ages with tissue viability issues, and of the elderly with chronic conditions commonly associated with wounds. Precisely, sufferers with multiple sclerosis and similar at risk of, or suffering from pressure ulceration, those with diabetes with foot ulceration, elderly patients with leg ulcers, especially with co-existing lymphovenous oedema. There are more, but my attention is directed at these groups with particular emphasis on those in care, or being cared for, in their own homes in England.
