This report is based on an advisory board meeting that took place in London on 7th February 2019. The meeting convened an expert group to discuss the use of negative pressure wound therapy (NPWT), and specifically NPWT with instillation and dwell time (NPWTi-d), for managing Category 3 and 4 pressure ulcers (PUs). The aims and objectives of the meeting were to identify why there is currently an underuse of NPWTi-d for Category 3 and 4 PUs in the UK; to understand how to align recommendations for NPWTi-d with the national strategy for PUs; to propose actions needed to change practice; to suggest a framework for integrating NPWTi-d for this indication across trusts in the UK.