Footcare focus at DPC

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During Limb Loss Awareness Month, DPC is focusing on the devastating impact of diabetes on foot and lower limb health.

More than 64,000 people with diabetes in England and Wales have foot ulcers at any given time, according to the most recent National Diabetes Footcare Audit (NDFA). Of these, only around 60 per cent are likely to survive five years.

Treatment for diabetic foot disease can involve amputation, with around 7,000 leg, foot or toe amputations in people with diabetes carried out in England every year. The NDFA found that the risk of lower limb amputation for people with diabetes is more than 20 times that of people without diabetes and only half of patients with diabetes who have had an amputation survive for two years.

Alongside the shocking human cost, diabetes foot disease also carries an enormous financial burden, with the cost to the NHS estimated at £1.2 billion a year.

Yet amputations are preventable, say experts, with improved awareness among patients of the risks of foot ulcers and faster access to multidisciplinary specialist footcare teams.

“The amputation rate is going up because we have more patients with diabetes,” says Graham Bowen, Clinical Lead for Podiatry, Solent NHS Trust. “However, 95% of amputations start with a single foot ulcer. So if we can get the screening and education right, we can prevent foot ulcers, which can then prevent amputations.”

The NDFA found the nationally recommended structures for managing diabetic foot disease often aren’t in place, and there is much variation in services and outcomes across the diabetes footcare pathway. For example, one in five hospital sites don’t have a multidisciplinary specialist footcare team.

Diabetic foot disease will be a key focus of DPC2018 in November. This will include the return of the DPC Foot & Wound Clinic, launched at last year’s show. This special feature will deliver the latest information and practical skills to help HCPs to support their patients in looking after their feet and lower limbs.

“The clinic looks at diabetic foot disease, taking it from basic screening right up to advanced care for those people who come into hospital, or we’re trying to keep out of hospital,” says Bowen, who will again be running the clinic with his highly experienced colleagues from the clinical podiatry team at Solent NHS Trust. “We’re looking to get as much information out to as many people as possible so they can inform and educate patients, and hopefully help prevent foot disease in the future.”

• Next month, the APPG for Diabetes will address the issue of ‘Diabetes and podiatry: how do we reduce amputations?’ in its May 10 meeting at the House of Commons. This will include a focus on: “How  CCGs can invest wisely in the Integrated Footcare Pathway and Multidisciplinary Specialist Footcare Teams to reduce amputations?”

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