24 June 2019
More patients with diabetes are receiving rapid, specialist foot care thanks to a new service at the Royal Free Hospital which is celebrating its first anniversary this week.
The ambulatory acute foot service runs seven days a week, allowing all emergency patients with diabetes and foot problems to be seen by a range of specialists who can give them appropriate care and advice – which helps them avoid amputation.
The service, which is led by the podiatry (foot care) department, is made up of staff from vascular surgery, infectious diseases and diabetology teams. Because patients receive the right specialist care at the right time, it means they are less likely to need an amputation and figures from the National Diabetic Foot Audit show that rapid specialist care can reduce healing times of foot ulcers and reduce complications.
Patients who have diabetes are at risk of amputation because the blood vessels and nerves in the foot and leg can become damaged, leading to a loss of circulation and a loss of feeling in their feet. When this happens, patients may injure their foot without realising it causing, ulceration or gangrene, spreading infection and amputation of the foot or leg.
Patients need care and support to address the problems with infection, blood flow and dead tissue, and to reduce pressure on the wound from walking. Otherwise, they are at risk of gangrene.
The service is funded by NHS England as part of a drive to reduce amputation rates.
Professor Richard Leigh, consultant podiatrist at the RFL and co-chair of the NHS England London Foot Care Network, said “We are now matching more patients with the right specialist more quickly. Managing foot conditions in diabetes are extremelychallenging and patients are at risk of amputation.”
“But we know if they can access the right specialist care urgently, we can reduce the number of patients who need an amputationand the morbidity and mortality associated with this. Obviously, this is a huge positive for the patients, but it also means the NHS saves money, as ulcerations and amputations and the after care patients require cost the NHS in England around £1billion a year.”
Picture caption: The podiatry team, including Richard Leigh far left.