Podiatrists have had a critical role to play during the pandemic1,2,3, particularly in preventing and treating diabetes and vascular associated foot ulceration, thereby reducing hospital admissions.
At the beginning of the pandemic, the Vascular Society of Great Britain and Ireland had suggested that performing primary amputation may be more appropriate than performing complex vascular reconstructions to reduce prolonged hospital stays4. Many GPs and healthcare professionals view people with intermittent claudication as needing to be referred to vascular teams for confirmation of diagnosis and suggestions on treatment intervention. Although vascular teams have remained open, they have had to prioritise access to surgical and endovascular treatments to those with the most severe life and limb-threatening vascular disease. Access for those with asymptomatic peripheral arterial disease or intermittent claudication (mild to moderate severity disease) has been limited4. The role of podiatrists in assessing and triaging suspected lower limb arterial disease, from mild asymptomatic disease, through to severe/critical ischaemia, has been essential in reducing pressure on primary care and supporting secondary care vascular teams5.
The College of Podiatry is promoting and supporting the vital role of lower limb arterial assessment and triage with its 10,000 members across the UK, working closely with vascular teams and general practice. The College has been promoting and providing a focus on access to early clinical diagnosis of peripheral arterial disease and optimised cardiovascular risk management, as well as amputation prevention. This has been realised via telemedicine consultations where possible, and face-to-face assessments where significant, severe, or deteriorating symptomatic disease is likely, reviewing cardiovascular risk profiles, medical history, and lower limb assessment, including ABPIs, toe pressures, and foot to femoral pulse checks.
The College of Podiatry has developed specific CPD modules on peripheral arterial disease for its members, to increase their knowledge and skills around cardiovascular risks, the National CVD Ambitions around atrial fibrillation, blood pressure and cholesterol, with the key link to lower limb arterial disease and prevention of associated cardiovascular morbidity and mortality.
Lawrence Ambrose
Martin Fox
The College of Podiatry
February 2021
References
At the beginning of the pandemic, the Vascular Society of Great Britain and Ireland had suggested that performing primary amputation may be more appropriate than performing complex vascular reconstructions to reduce prolonged hospital stays4. Many GPs and healthcare professionals view people with intermittent claudication as needing to be referred to vascular teams for confirmation of diagnosis and suggestions on treatment intervention. Although vascular teams have remained open, they have had to prioritise access to surgical and endovascular treatments to those with the most severe life and limb-threatening vascular disease. Access for those with asymptomatic peripheral arterial disease or intermittent claudication (mild to moderate severity disease) has been limited4. The role of podiatrists in assessing and triaging suspected lower limb arterial disease, from mild asymptomatic disease, through to severe/critical ischaemia, has been essential in reducing pressure on primary care and supporting secondary care vascular teams5.
The College of Podiatry is promoting and supporting the vital role of lower limb arterial assessment and triage with its 10,000 members across the UK, working closely with vascular teams and general practice. The College has been promoting and providing a focus on access to early clinical diagnosis of peripheral arterial disease and optimised cardiovascular risk management, as well as amputation prevention. This has been realised via telemedicine consultations where possible, and face-to-face assessments where significant, severe, or deteriorating symptomatic disease is likely, reviewing cardiovascular risk profiles, medical history, and lower limb assessment, including ABPIs, toe pressures, and foot to femoral pulse checks.
The College of Podiatry has developed specific CPD modules on peripheral arterial disease for its members, to increase their knowledge and skills around cardiovascular risks, the National CVD Ambitions around atrial fibrillation, blood pressure and cholesterol, with the key link to lower limb arterial disease and prevention of associated cardiovascular morbidity and mortality.
Lawrence Ambrose
Martin Fox
The College of Podiatry
February 2021
References
- NHS England and NHS Improvement. COVID-19 prioritisation within community health services. 2020. https://www.england.nhs.uk/coronavirus/publication/covid-19-prioritisation-within-community-health-services-with-annex_19-march-2020/
- Scottish Government. Coronavirus (COVID-19): nursing and community health staff guidance. 2020. https://www.gov.scot/publications/coronavirus-covid-19-nursing-and-community-health-staff-guidance/
- NHS England and NHS Improvement, Health Education England and the Department of Health & Social Care, Welsh Government, Department of Health, Northern Ireland, Scottish Government, Health and Care Professions Council, General Osteopathic Council, Allied Health Professions Federation, Council of Deans of Health. Supporting allied health professionals and allied health professional support workers during the COVID-19 epidemic in the UK. 2020
https://www.england.nhs.uk/coronavirus/publication/letter-supporting-allied-health-professionals-and-allied-health-professional-support-workers-during-the-covid-19-epidemic-in-the-uk/ - The Vascular Society of Great Britain and Ireland. 2020. The VSGBI statement on Covid-19 and vascular https://www.vascularsociety.org.uk/professionals/news/113/covid19_virus_and_vascular_surgery
- Chadwick P, Ambrose L, Barrow R, Fox M. 2020. A commentary on podiatry during the Covid-19 pandemic - Podiatry during the Covid-19 pandemic, Journal of Foot and Ankle Research, 13:63 https://doi.org/10.1186/s13047-020-00425-9