A Serious and Preventable Harm

As a solicitor specialising in clinical negligence, I have acted for many individuals who have suffered serious harm as a result of pressure sore injuries—also known as pressure ulcers, pressure injuries, or bed sores. These are often wrongly assumed to be minor or inevitable. In reality, they are often avoidable, painful, and can lead to long-term, sometimes life-altering consequences.

This post explains what pressure sores are, how they should be prevented in hospital and care settings, and the circumstances in which a claim for clinical negligence may arise.

What Are Pressure Sores?

The National Institute for Health and Care Excellence (NICE) defines a pressure ulcer as:

“Localised damage to the skin and/or underlying tissue, usually over a bony prominence, as a result of sustained pressure, or pressure in combination with shear.”

Pressure sores can range from superficial skin discolouration (Grade 1) to full-thickness wounds exposing muscle or bone (Grade 4). Common sites include the heels, sacrum, hips, and elbows.

The terms “pressure sore”, “pressure ulcer”, “pressure injury”, and “bed sore” are used interchangeably, but all refer to the same clinical condition.

Pressure Injuries Should Not Be Underestimated

Pressure sores are often preventable if clinical guidelines are followed. These injuries can take many months—or even years—to heal and are often accompanied by:

• Severe pain
• Reduced mobility
• Risk of infection or sepsis
• Psychological distress
• Loss of independence
• Increased care requirements

In serious cases, patients may require hospital admission, surgical intervention, pressure-relieving equipment, and ongoing specialist nursing care. The impact on quality of life can be profound.

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Proper Prevention Is Essential

Hospitals, care homes, and community care providers have a legal and clinical obligation to implement preventative measures in line with national guidelines and internal protocols. These should include:

1. Initial Risk Assessment

All patients—especially those who are immobile, elderly, or seriously ill—must undergo a full risk assessment. Commonly used tools include:

• The Waterlow Score
• The Braden Scale
• The Norton Scale
• Purpose T

These frameworks assess key factors such as mobility, skin condition, continence, nutrition, and overall health.

2. Regular Skin Inspection

A baseline skin assessment should be carried out promptly and then reviewed regularly. Particular attention should be paid to vulnerable areas, and any changes in risk status must prompt reassessment.

3. Development of a Robust Care Plan

If risk is identified, a comprehensive individualised care plan must be put in place to manage the risk identified within the risk assessment. This plan should manage and mitigate the risk of developing pressure injury.  These plans  should cover (amongst other things):

• Use of specialist pressure-relieving equipment (e.g. air mattresses, cushions)
• Regular repositioning schedules
• Hydration and nutritional support
• Daily or more frequent skin inspections
• Effective continence management
• Training and supervision of staff

4. Implementation and Ongoing Review

A care plan must not only be drafted—it must be enacted. Moreover, it should be continually reviewed and adapted in response to the patient’s condition. A static care plan, even if initially sound, can become negligent if not revised when a patient deteriorates or fails to respond.

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Where Things Go Wrong: Failures Giving Rise to Negligence

In many of the pressure sore cases I have handled, negligence has arisen from one or more of the following failings:

• Failure to carry out timely or accurate risk assessments and therefore for the clinical staff to not appreciate the clinical risk for an individual patient
• Inadequate or delayed skin assessments
• Absence of a care plan or failure to implement one
• Use of inappropriate or outdated equipment
• Failure to turn or reposition immobile patients
• Poor hydration and nutrition support
• Inadequate documentation or handover between shifts
• Failure to act when signs of breakdown begin to appear

Evaluation and response to interventions is essential so treatment plans can be changed. Clinical teams must be alert to these developments and adapt plans accordingly. A failure to do so is often a key element in a successful claim.

Advice for Those Affected by Pressure Injuries

If you or a loved one has developed a pressure sore whilst in hospital, a care home, or while receiving care in the community, it is important to seek legal advice. These injuries are not simply unfortunate side effects of illness or ageing—they are often the result of poor care.

I am a specialist clinical negligence solicitor with a professional interest in pressure sore injury claims. I work with medical experts and support clients through the legal process to obtain compensation and ensure their ongoing care needs are properly addressed.

To discuss your case in confidence, please get in touch.