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Why we’re urging NHS England to invest in diabetes foot care

Footcare - doctor with patient examining the foot

We can reveal 27,465 diabetes-related lower limb amputations have been carried out over the last three years. Yet 1 in 6 hospitals still don’t have the specialist foot care teams needed to ensure patients receive a high quality of care. This needs to change. 

Diabetes is the most common cause of lower limb amputations in the UK

We can reveal that there were 27,465 lower limb amputations related to diabetes in England from 2015 to 2018, marking a significant increase of 18.3% from 2011 to 2014. Major amputations, defined as below the knee, were up by 8.8%, whilst minor amputations, defined as below the ankle, were up by 22.4%. 

Someone living with diabetes is 20 times more likely to experience an amputation than someone without the condition. This is because high blood sugar levels can damage blood vessels, affecting how blood flows to the feet and legs. 

Unhealed ulcers and foot infections are the leading cause of diabetes related amputations, with diabetic foot ulcers preceding more than 80% of amputations.

Both foot ulcers and amputations are also hugely costly for the NHS, with at least £1 in every £140 of NHS spending going towards foot care for people with diabetes. 

Why are numbers increasing?

This rise in diabetes related amputations are partly due to the fact that 1 in 6 hospitals still do not have multidisciplinary specialist foot care teams (MDFT). These teams, which often include podiatrists, physicians and nurses, are integral to delivering a high quality of care and their absence may result in inconsistent access to treatment and outcomes across the nation. 

For people with diabetes, problems with the feet arising from foot ulcers and infections can develop and deteriorate very quickly. That’s why people with diabetes need rapid access to an MDFT when they have a foot problem. 

Dr Rob Mannion, 73, Bournemouth, has charcot foot. He said:

“Over the years, I’ve suffered from a number of foot care complications. But every time I’ve received absolute first class treatment, and this is partly due to my hospital having a multidisciplinary specialist foot care team.
 
When I began to have issues with my feet, the team kept a very strict eye on me and have helped me every step of the way. Without their expertise and the consistent quality of care – things could have been a lot worse for me.”

Evidence shows the longer the delay before being seen by an MDFT, the more likely it will be that foot ulcers become severe and slow to heal, increasing the risk of amputation.

We want action

Foot problems can be devastating to a person’s quality of life and are often life-threatening. That’s why we’re urging NHS England to deliver on its commitment made in the NHS Long-Term Plan to invest further in developing diabetes foot care, so that all hospitals provide access to a MDFT.

Dan Howarth, Head of Care at Diabetes UK, said:

“Ensuring that multidisciplinary specialist foot care teams are in every single hospital across the country will not only significantly improve outcomes for people with diabetes, it will also cut down on long-term costs to the NHS.
 
The differences in the standard of treatment between areas is unacceptable. An amputation, regardless of whether it’s defined as minor or major, is devastating and life-changing. A ‘minor’ amputation can still involve losing a whole foot. Especially as many diabetes amputations are avoidable through better quality care – we have to do better.
 
To stop this upward trend in amputations, we are urging NHS England to stay true to their commitments and ensure people with diabetes have access to the specialist care and support they need.” 

A matter of hours can make the difference between losing and keeping a foot. This is why it’s vital for all people living with diabetes to know how to look after their feet, to check them regularly to look out for the signs of foot problems and to know when to seek medical attention.

Learn more about diabetes and foot care

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