1.1 Summarise the current legislation, national guidelines, policies, protocols and good practice guidelines which inform undertaking treatments and dressings of lesions and wounds

This guide will help you answer 1.1 Summarise the current legislation, national guidelines, policies, protocols and good practice guidelines which inform undertaking treatments and dressings of lesions and wounds.

Treating wounds and lesions involves proper cleaning, assessment, dressing application and review. Healthcare workers must follow legal and professional guidelines at every stage. Doing so protects patient safety and helps achieve the best outcome. Several acts, NHS policies, best practice guidelines and local protocols lay out the right approach.

Legislation Governing Wound Care

The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014

This Act sets standards in England for those delivering health and adult social care. The regulations from this Act focus on safety and quality. Regulation 12 covers safe care and treatment. This places a duty on service providers and workers to prevent avoidable harm and to provide care and treatment in a safe way.

For wounds and lesions, this means:

• Assess each wound properly before treatment.
• Use clean and sterile techniques where needed.
• Keep clear and accurate records about treatments.
• Always seek advice or escalate if outside your own competence level.

The Mental Capacity Act 2005

Some people may not be able to consent to treatment, such as those living with dementia. The Mental Capacity Act 2005 tells us how to work within the law when making decisions for people who cannot do this for themselves. Every adult is treated as able to make their own decisions unless proven otherwise. If someone cannot consent to dressing changes, you must act in their best interests and follow legal processes.

This means:

• Always assess capacity before carrying out wound treatment.
• Support the person to make their own choices, with suitable explanations.
• Involve advocates or relatives if appropriate.
• Document capacity assessments and best interest decisions.

The Data Protection Act 2018 and UK GDPR

This law explains how to handle confidential information, such as records about a person’s wounds or treatments. You must keep written and digital records secure. Always limit access to those who need the details for care.

• Keep care notes locked away or password protected.
• Do not discuss wound care details in public spaces.
• Gain permission before sharing information about someone’s wound or treatment with other services or family members, except in cases of safeguarding.

The Health and Safety at Work etc. Act 1974

This law covers keeping everyone safe in the workplace. It places duties on employers and workers. You must use safe practices, report hazards and use equipment and dressings safely. This protects both the person you are supporting and yourself.

For wound care, this means:

• Using gloves, aprons, and disposing of dressings correctly.
• Reporting spills, needle stick injuries or equipment faults.
• Responding quickly to injuries or contamination.

The Control of Substances Hazardous to Health (COSHH) Regulations 2002

Wound treatments may involve chemicals or contaminated waste. COSHH tells you how to use and dispose of these safely.

For example:

• Use approved cleaning products and dressings.
• Store wound care items correctly.
• Dispose of used dressings and chemicals using clinical waste procedures.

National Guidelines and Standards

National Institute for Health and Care Excellence (NICE) Guidelines

NICE issues regularly updated guidance for health and care workers. These include specific recommendations about managing wounds. Some of their key relevant guidance includes:

CG179 – Pressure Ulcers: Prevention and Management

NICE CG179 covers how to prevent, identify and treat pressure ulcers (sometimes called pressure sores or bedsores). This guideline states:

• Assess every person on admission for risk of pressure ulcers.
• Use suitable, evidence-based dressings to promote healing.
• Reassess regularly and report any changes quickly.
• Do not use dressings or treatments that are not recommended for the wound type.

CG174 – Intravenous Fluid Therapy in Adults in Hospital

While not only for wound care, it addresses wound healing in relation to hydration and overall health.

Infection Prevention and Control in Care Homes

NICE provides guidance for preventing cross infection when dealing with wounds and dressings. This includes:

• Good hand hygiene before, during and after care.
• Using sterile dressings for open or new wounds.
• Cleaning equipment and surfaces thoroughly.

SIGN Guidelines (Scotland)

The Scottish Intercollegiate Guidelines Network (SIGN) offers advice for those in Scotland. SIGN 136 and SIGN 120 set out wound management standards.

• It is important to follow any national guidance for your country within the UK.

Policies, Protocols and Procedures

Organisational Policies

Each care provider, including NHS trusts and care homes, will have their own written wound care policy. These documents describe exactly how to provide treatment in that workplace. They usually include:

• Which members of staff may change which types of dressings.
• Instructions for using cleaning solutions and dressings.
• Risk assessments for infection or wound deterioration.
• How and where to record care provided.
• When to refer to other professionals, such as a nurse or tissue viability team.

Always read and follow your local organisation’s guidelines, as these may add extra requirements to national rules.

Local Protocols

Protocols are clear step-by-step plans for particular wounds or treatments. Examples include protocols for pressure ulcers, leg ulcers, diabetic foot wounds, or post-surgical wounds. These may detail:

• The type of dressing to use at each wound stage.
• How often to check and change dressings.
• Signs of infection to look for.
• When to involve a senior nurse or specialist.

Protocols back up clinical judgement and help deliver safe, effective care.

Clinical Governance

Clinical governance is an umbrella term for systems that maintain and improve care quality. It covers reporting incidents or near misses, reflecting on practice, learning lessons, and making service changes after reviews.

For wound care, this means you should:

• Record any unexplained skin damage or worsening wounds quickly.
• Report incidents or near misses without delay.
• Take part in training and updates about wound care.

Good Practice Guidelines

Professional bodies issue best practice advice. These set expectations for all health and care workers, even when not enforced by law.

The Royal College of Nursing (RCN) Wound Care Guidance

The RCN publishes guidance such as “Wound management” and recommends:

• Use an aseptic (clean) technique if the wound is new or at risk of infection.
• Moist wound healing is better than allowing wounds to dry out.
• Assessment of the wound and general health before, during and after treatment.
• Document all observations and treatments clearly.

Tissue Viability Society Guidance

The Tissue Viability Society is a UK expert group. Their guidance helps with more complex wounds, such as bedsores, diabetic ulcers and chronic (long-lasting) wounds. Their recommendations include:

• Using pressure-relieving mattresses and cushions for those at high risk.
• Regularly checking for changes in wound appearance.
• Only using off-licence treatments (those not licensed for wounds) after discussing risks and gaining consent.

NHS Wound Care Formulary

Many NHS organisations use a wound care formulary. This is a list of approved dressings and treatments supported by evidence. Using the formulary avoids using inappropriate or costly products.

• Always check the specific formulary for your workplace when choosing a dressing.
• Do not use products not included unless directed by a qualified healthcare specialist and documented.

Principles and Definitions

Informed Consent

Before you clean or dress someone’s wound, you need their permission and understanding (known as informed consent). The person should know:

• What the treatment will involve.
• Why it is being done.
• What could happen if they refuse.
• Any risks or alternatives available.

Record clearly that consent has been given or refused.

Aseptic Technique

An aseptic technique is a way of working that prevents introducing germs when touching a wound. It involves:

• Using sterile gloves, dressings, and equipment.
• Cleaning your hands thoroughly.
• Not allowing anything unclean to touch the wound.

Many policies require an aseptic technique for all invasive or high-risk dressings.

Hand Hygiene

Hand hygiene means cleaning your hands effectively before and after wound care. It is the most effective action to stop infection spreading. This may mean washing with soap and water or using alcohol hand gel, as the workplace policy states.

Infection Control

Infection control is the process of stopping harmful bacteria or viruses spreading. Wound care policies may require:

• Use of gloves and aprons.
• Safe disposal of used dressings in special sealed bags.
• Cleaning all tools and trays with approved products after each use.
• Covering cuts or grazes on your own hands.

Examples of National and Legal Guidance Cited in Practice

• Health and Social Care Act (Regulated Activities) Regulations 2014: Covers provision of safe care and treatment, risk assessment, infection control and record keeping.
• NICE CG179/NG89: Sets standards for wound assessment and management.
• Mental Capacity Act 2005: Sets out rights, consent, and acting in the best interests of those without capacity.
• CQC Fundamental Standards: Inspection body standards covering dignity, safety and record keeping.
• RCN Guidance: Professional standards for the assessment, documentation and delivery of wound care.
• Tissue Viability Society: Specialist advice for complex wounds.

Practical Steps in Line with Guidance

To meet legal and best practice guidelines:

• Check and document the type, size and appearance of every wound or lesion.
• Choose the right dressing for the wound’s stage and your workplace’s formulary.
• Use the correct technique (aseptic or clean) according to your policy and the wound.
• Wear gloves, apron and any other required personal protective equipment.
• Dispose of used dressings, gloves, and cleaning materials in line with local policy.
• Complete and update care records immediately after treatment.
• Seek support if the wound looks worse, the person is in pain, or you are unsure.

Final Thoughts

By following up-to-date laws, guidance and policies, you will support the well-being and recovery of those in your care. Remember that best practice is always developing, so it is important to keep yourself updated and to follow your workplace’s most recent protocols.