The National Wound Care Strategy Programme (NWCSP) has now been underway for 12 months. In England, wound care is a somewhat piecemeal enterprise and much of last year has been spent on understanding the current situation. As predicted, we have found over-use of treatments for which there is little evidence of improved healing and underuse of treatments which are known to be highly effective. Too often, patients with chronic wounds are not being offered the care that is known to promote healing, improve quality of life and make the best use of NHS resources. The desire to deliver excellent care is too frequently defeated by overwhelming demand on fragmented services or a shortage of clinicians with relevant knowledge and skills. However, there are pockets of excellence and we are making links with these ‘green shoots’ which we will work with to seed improved practice across England.