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Diabetes and footcare

Up to 80 per cent of people with diabetes die within five years of having an amputation or a foot ulcer. Evidence shows that providing an integrated footcare pathway, with trained staff in foot protection services in the community and speedy access to multidisciplinary specialist teams, considerably lowers the risk of amputation.

Use the following resources and tools to improve footcare for people with diabetes.

Publications

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Improving footcare for people with diabetes and saving money: an economic study in England, Insight Health Economics for Diabetes UK (January 2017) (PDF, 59KB)

This summary report presents new estimates of the costs of diabetes-related amputations and foot ulcers in England. It also updates estimates of the numbers of people with diabetes experiencing foot ulcers and examines the potential to improve care and reduce costs. Download thefull report(PDF, 1.3MB).

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How to: use root cause analysis to reduce diabetes related amputations, Diabetes UK (June 2016) (PDF, 489KB)

This guide provides practical, step-by-step information on how to complete root cause analysis (RCA). It includes who to involve, how to gather the right data, and techniques to help identify root causes. Download thetools and templates featured in the guide.

Adapting the Ipswich Touch Test to increase foot risk assessments at the Royal Free Hospital, Diabetes UK (August 2016) (PDF, 363KB)

This bright idea describes how the Royal Free Hospital created a foot risk assessment tool based on the Ipswich Touch Test. Since introduction of the tool, the percentage of people with diabetes who received a foot risk assessment on admission increased from 6.5 per cent in 2013 to 40 per cent in 2015. Download thetoolfeatured in the bright idea (PDF, 42KB).

Fixing footcare in Sheffield: improving the pathway, Diabetes UK (February 2015) (PDF, 258KB)

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Fixing footcare in Sheffield: improving the pathway, Diabetes UK (February 2015) (PDF, 258KB)

This case study describes how the diabetes team at Sheffield Teaching Hospitals NHS Foundation Trust significantly reduced their amputation rates by introducing some simple, proven quality improvement approaches.

Integrated footcare pathway, Diabetes UK (May 2017) (435 KB) 

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Integrated footcare pathway, Diabetes UK (May 2017) (435 KB) 

This resource provides information for commissioning and planning an integrated footcare pathway and includes a patient risk stratification and triage tool.

Putting feet first: six step guide to improving diabetes footcare, Diabetes UK (June 2017) (PDF, 668KB)

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Putting feet first: six step guide to improving diabetes footcare, Diabetes UK (June 2017) (PDF, 668KB)

This resource outlines the six steps CCGs can take to improve foot care and reduce amputations in their local area.

Essential reading

  • National improving diabetes footcare conference report, Diabetes UK (June 2016) (PDF, 640KB)

    This report provides an overview of the national improving diabetes footcare conference - a collaborative project between Diabetes UK and the National Diabetes Footcare Audit (NDFA). The report includes a summary of the workshops, copies of the presentations and a summary of the round table discussions about how the NDFA recommendations can be taken forward.This report provides an overview of the national improving diabetes footcare conference - a collaborative project between Diabetes UK and the National Diabetes Footcare Audit (NDFA). The report includes a summary of the workshops, copies of the presentations and a summary of the round table discussions about how the NDFA recommendations can be taken forward.
  • Commissioning guidance: footcare service for people with diabetes, London Strategic Clinical Networks website (May 2015)

    This guidance and sample service specification outlines the care that should be provided by each component of an integrated diabetes foot service according to best practice and guidance published by NICE and Diabetes UK.This guidance and sample service specification outlines the care that should be provided by each component of an integrated diabetes foot service according to best practice and guidance published by NICE and Diabetes UK.
  • The development of a foot protection service for people with diabetes, Diabetes on the Net website (2015) (free, login required)

    This article describes how to develop a local foot protection service for people with diabetes and summarises the clinical roles within the service.This article describes how to develop a local foot protection service for people with diabetes and summarises the clinical roles within the service.
  • Best practice renal foot care guidance, London Strategic Clinical Networks website (November 2015)

    This docuement brings together clinical consensus on best practice foot care for people with renal disease. The development of this document is an opportunity for commissioners and providers to ensure all patients with renal disease can access good quality foot care in an appropriate setting that is holistic and centred around their needs.This docuement brings together clinical consensus on best practice foot care for people with renal disease. The development of this document is an opportunity for commissioners and providers to ensure all patients with renal disease can access good quality foot care in an appropriate setting that is holistic and centred around their needs.
  • Footcare for people with diabetes: the economic case for change, NHS Diabetes (March 2012) (PDF, 9.6MB)

    This report estimates the cost to the NHS of foot care services for people with diabetes and provides an estimate of the impact of improving care. The report also explores the impact of multidisciplinary teams on patient outcomes and NHS costs.This report estimates the cost to the NHS of foot care services for people with diabetes and provides an estimate of the impact of improving care. The report also explores the impact of multidisciplinary teams on patient outcomes and NHS costs.

Shared practice examples

  • Using root cause analysis to improve footcare, Diabetes Update (August 2016) (PDF, 3.5MB)

    This article describes how Harrogate and District NHS Foundation Trust have used used root cause analysis to improve diabetes footcare and how they make it work for their patients.This article describes how Harrogate and District NHS Foundation Trust have used used root cause analysis to improve diabetes footcare and how they make it work for their patients.
  • Training non-podiatrists to assess foot risk as part of an integrated foot service, NICE website (February 2016)

    This case study presents how The Newcastle upon Tyne Hospitals NHS Foundation Trust trained practice nurses in undertaking diabetic foot assessments, enabling those at low risk to remain in primary care for their annual assessments and those at high risk or with an active diabetic foot problem to be seen by the podiatry service.This case study presents how The Newcastle upon Tyne Hospitals NHS Foundation Trust trained practice nurses in undertaking diabetic foot assessments, enabling those at low risk to remain in primary care for their annual assessments and those at high risk or with an active diabetic foot problem to be seen by the podiatry service.
  • Improving foot health, a toolkit, Diabetes Modernisation Initiative website (April 2014)

    This toolkit shows how the Diabetes Modernisation Initiative dramatically improved the foot health of people living in Lambeth and Southwark. The toolkit presents the DMI approach, outcomes, tips and further resources.This toolkit shows how the Diabetes Modernisation Initiative dramatically improved the foot health of people living in Lambeth and Southwark. The toolkit presents the DMI approach, outcomes, tips and further resources.
  • Check, protect, refer (CPR) for feet, Diabetes on the Net website (2014) (free, login required)

    This article describes the check, protect, refer campaign in Scotland, an initiative designed to reduce the number of people with diabetes developing foot ulcers while in hospital.This article describes the check, protect, refer campaign in Scotland, an initiative designed to reduce the number of people with diabetes developing foot ulcers while in hospital.

Resources

E-learning

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