In April 2011 Midlands and East Strategic Health Authority (SHA) set the goal of eliminating all avoidable category 2, 3, and 4 pressure ulcers. The work on pressure ulcers originally started in the East of England SHA prior to the merger with both East and West Midlands as part of the Safe Care workstream for the national QIPP Safety Express programme initiated in January 2011. A working group was convened in late September 2011 to look at what resources existed in the region and what commonalities and differences there were within pressure ulcer prevention and management within the region. The working group consisted of three clinical staff (tissue viability nurses), an educator (specialising in tissue viability), and a range of management and strategic staff. The group used an existing regional group – the East of England Tissue Viability Network – to get rapid feedback on all their proposals. Following the merger with the other two SHAs, the group also made contact with the local tissue viability groups from those regions. The working group met once a fortnight and reported to a Pressure Ulcer Board chaired by Dr Paul Watson.