In 2005 a national survey was conducted to assess the use of vacuum assisted closure across primary and secondary care settings. It was found that although tissue viability nurses are primarily responsible for the management of complex wounds in both primary and secondary care, in some cases, concerns were raised regarding responsibility for follow up and review, particularly when patients were discharged from hospital. In many cases the TVN was the key link between care settings. One of the major barriers for TVNs was the ease of access to VAC in community settings.