The College of Podiatry welcomes call for specialist footcare teams

The research found that from 2015 to 2018 there were 27,465 lower limb amputations related to diabetes in England, suggesting the rate of amputation linked to diabetic ulcers has increased by 18.3% from the previous period.

Only one in six hospitals in England currently have established multidisciplinary foot care teams. Diabetes UK is now calling for NHS England to increase investment in diabetes foot care to ensure all hospitals in England can provide patients with rapid access to a team of foot care specialists, including podiatrists, that are essential to the early diagnosis and treatment of foot ulcers.

Dr Paul Chadwick, Clinical Director at the CoP, comments:

“These shocking statistics underline the need to raise awareness among those suffering from and at risk of developing diabetes, including the life-altering repercussions associated with the disease. Foot ulcers and amputations not only have a devastating impact upon people’s lives, but also increase their morbidity - up to 70% die within five years of having an amputation and around 50% die within five years of developing a diabetic foot ulcer.

“Podiatrists are highly skilled in the detection of foot ulcers that regularly precede amputations, and can therefore play a crucial role in the prevention of avoidable amputations – in fact it’s estimated that half of these foot and leg amputations could be avoided, if more people with foot problems, and particularly diabetes sufferers, regularly visit a podiatrist for expert treatment.

“With foot disease in people with diabetes now costing the NHS in England an estimated £1-1.2 billion every year, and a quarter of those with diabetes unaware that they have the disease, it is in the national interest to ensure multidisciplinary specialist foot care teams are present in all hospitals, and also in primary care settings.”

The CoP advises that all people who are currently low risk for foot ulceration should have an annual foot screen carried out with their GP, and that all people identified at their screen as increased risk should be offered a referral to the Foot Protection Service. All people with diabetes should be given verbal and written advice about their risk status and how to access foot services urgently if they develop a problem.

For people with diabetes to minimise the risk of developing foot problems, the CoP advises the following:

• Check your feet every day for any injuries or hard skin, as damaged skin can sometimes cause an ulcer to form   
• You should have an annual foot check and be advised of your risk
• If you are considered at risk, you should see a podiatrist regularly
• Control your blood glucose levels, cholesterol and blood pressure to prevent or slow down any changes to the nerves and blood vessels that supply your legs and feet
• Lead an active lifestyle and abstain from smoking
• Always wear footwear and ensure that your shoes fit properly.    

Podiatrists are experts in foot health and are highly skilled in the detection of foot ulcers that regularly precede amputations. For more information, please visit our Patient information pages.

The College has developed and recently updated the Diabetes Commissioning Toolkit which gives local data on the rates and costs of complications for each health area in England.