It will ensure that the standards issued in 2004 by NICE for the delivery of high-quality foot care can be achieved. The need for better foot care was highlighted at the 2006 Diabetes UK Annual Professional Conference in Birmingham in March, which showed that more than a quarter of people with diabetes who were thought to be at high risk of having an amputation were not offered any kind of specialist appointment.
This is the first framework for foot care services for diabetes that states how foot care should be delivered and what skills healthcare workers responsible for it should possess.
There is a lack of diabetes specialist podiatrists available, which means that other healthcare professionals in primary care organisations will have a crucial role to play in providing effective foot care. According to the framework, which has been developed by leading UK diabetes charities and societies, annual foot checks should be carried out by an appropriately trained healthcare professional.
It states that the risk status of a patient should be assessed by identifying the presence of sensory neuropathy, when the arterial supply to the foot is reduced, the presence of deformities and/or the abnormal build up of callus.
It is important that healthcare professionals discuss the patient’s individual level of risk and agree plans for future surveillance.
County Down GP, Dr Colin Kenny, chairman of the Primary Care Diabetes Society, backed the framework as clear and well expressed.
Dr Niti Pall, a GPSI in diabetes in the West Midlands, said: ‘In our practice, we train healthcare assistants to carry out the foot tests. But there are a lot of different types of skill mix, so this guidance would be very useful for our healthcare assistants.
‘The serious cases will be referred to the GPs who have sufficient expertise to successfully treat patients,’ she added.
Zoe Harrison, care advisor at Diabetes UK, one of the societies involved in the development of the framework, said: ‘We hope that this new framework will fill the gap around foot care.’