Abstract
Compression therapy is the cornerstone, first-line effective evidence-based treatment for healing and managing venous leg ulcers. However, compression therapy is inconsistently applied in hospitals. This paper explores the experiences of a diverse group of clinicians and senior managers applying compression therapy in hospitals across the United Kingdom. A semi-structured qualitative interview study was conducted with 19 participants, drawn from a larger study, who confirmed that their respective hospitals apply compression therapy to inpatients with venous leg ulcers. The interviews were analysed using reflexive thematic analysis. Analysis generated four key themes: Patients 'slip through the net', Prioritisation in Hospital Care, A 'blind Spot' within Healthcare System and Motivation to Deliver Care. Patients 'slip through the net' refers to inpatients with venous leg ulcers face unequal access to compression therapy both within and between hospitals. Prioritisation in Hospital Care indicates how certain diseases are given greater emphasis within healthcare systems. A 'blind Spot' in Healthcare System described failing to implement compression therapy has created a critical underlying 'blind spot' within the NHS healthcare systems. Motivation to Deliver Care refers to a deep commitment to providing compression therapy, driven by clinicians' inherent dedication and ethical obligation towards improving patient quality of care. The study identified key challenges influencing the application of compression therapy in acute hospitals despite its routine use. These include the lottery of care, systemic inequities, unclear ownership, interprofessional disputes and organisational priorities. It also demonstrated the significant role of passion, motivation and moral responsibility encouraging clinicians to implement compression therapy despite these systemic barriers.