One was concerned with ensuring that the nurses had the skills to undertake proper assessments using Doppler equipment. The other was to ensure that nurses had the skills to apply compression bandaging. These sessions were effective in developing the skills of the district nurses. Fourth, ways had to be found to cover the short term costs of additional multi-layer compression bandaging which at the time could not be prescribed but was available on the FP10. The practice agreed to fund the initial costs from savings on the fundholding budget.
Subsequent changes allow compression bandaging to be prescribed.
After their training the four district nurses started to apply their new skills in April 1998. A thorough assessment of the patients was undertaken which in addition to the necessary Doppler investigation included photographing and tracing the ulcer to determine its size. With hindsight the practice recognised that they could have done more to lay plans to measure the benefits of the work. Nevertheless the impact of the work was visible to patients, nurses, and general practitioners. This success was acknowledged when the practice was awarded Beacon status in 1999.