Being lead of the diabetes foot[2012] and Co-chair of West Midlands network [2016], I have worked closely with Primary Care and Vascular surgeons to introduce integrated pathways and associated education sessions resulting in reduction of amputation rate consistently in Coventry and Rugby CCG. The risk stratified pathway with traffic light system, colour coding and referral information on every foot condition including vascular problems is published in GP gateway website and is easily accessible to all in the community. It has clear contact links and criteria for foot protection and referral for tertiary care. This was also commissioned by the Coventry CCG in September 2012 and I have since led educational sessions for Primary Care team to promote its implement. This has resulted in early referral and reduced the amputation rate for Coventry which is one of the lowest in England. Close working with the Vascular team led to the establishment of foot multidisciplinary team[MDT] resulting in reduced admissions and reduced length of stay for foot patients [Public Health England] .Inception of monthly foot MDT to discuss timely management of complex foot patients ,training and research. Service has been recommended by the West midlands Quality review Committee. As a co-chair of the Diabetes Foot Care Network in West Midlands, which is part of the cardiovascular network, I drive the use of peer review; encourage critical assessments of current pathways and use of Root cause analysis for any significant events. Through this role, I have been able to promote a culture of continuous improvement and have been able to address some of the health inequalities that exist within our systems. I have been selected as a diabetes UK clinical champion for the above work.