Data on chronic wounds and how it affects people who live with such conditions as well as its impact on health services (Guest et al, 2015) brought into sharp focus the need to have a more unified and strategic approach to wound care — NHS England’s Leading Change Adding Value programme (NHS 2016a) has taken up the challenge. This article aims to highlight the extent of the burden of chronic wounds in relation to the lower limb and to describe the national workstream project that supported a nationwide conversation about services and care, and the development of a framework for lower limb management.