Addressing the cost of contractures

Contractures are costly; the human cost in terms of the loss of independence, function, and quality of life is harrowing; and we also recognise the cost on the system regards increased care needs, medication and medical interventions. 

We believe that anything that can help prevent or identify these at the earliest stage of development is key. The commitment across professional groups and organisations to try and improve this has been fantastic, and from speaking to colleagues across the UK we are all seeing the same concerns.

Dorset Healthcare is a community-based NHS foundation trust and many of our teams are approached by care homes requesting training on how best to manage their residents who may be experiencing joint contractures. 

As part of a QI-driven project – and with carer co-design – we have created a short contracture awareness video. The evidence behind the content has been generated by a match-funded PhD between Dorset Healthcare and Bournemouth University developing a risk tool to assist in the early detection of contracture development. 

The tool is called ORACLE (Observational Risk Assessment of Contractures: Longitudinal Evaluation) and it will be the first validated tool of its kind. 

In developing the tool, the research project included an extensive systematic review which identified the factors associated with the development of and progression of contractures. 

From speaking to colleagues across the UK we are all seeing the same concerns.

This will underpin ORACLE, but we also wanted to extract that learning and make it accessible to care staff. Through co-design we recognised the need for clear preventative advice that could be easily accessed quickly. We would encourage the video to be shared as widely and freely as possible and hope that fellow CSP members will feel that it is helpful for patients, families, formal and informal carers.