The Royal College of Podiatry's response to the 10-year health plan for England

These changes present both opportunities and significant challenges for those delivering services in England. However, the RCPod urges the government to fully harness the unique and untapped potential of podiatry to achieve these goals, especially given the growing burden of long-term conditions and the workforce challenges facing the profession.

A core strength of the 10-year plan is its emphasis on local delivery and preventative care. These principles are fundamental to podiatry. Podiatrists offer accessible, patient centred care, that not only addresses immediate foot and lower limb issues but also prevents serious complications, reduces hospital admissions, and supports people to live healthy, active lives.

With over 5.6 million people living with diabetes in the UK, podiatrists are vital in the early detection, prevention and management of complications such as peripheral arterial disease, foot ulceration, infection, and amputation. These long-term conditions and complications are not only devastating for patients but also place a significant financial strain on NHS services. Through short term investment for longer term improvement in outcomes in podiatry-led preventative interventions, the NHS can reduce avoidable hospital admissions and surgical interventions, improve quality of life and mobility for people with long-term conditions.

Investment in podiatry services can also address the plan’s aim to reduce health inequalities. In socio-economically deprived areas, rates of peripheral arterial disease, foot ulceration, and amputation are more prevalent. The RCPod urges the government to provide enhanced funding and support for podiatry services – particularly in communities with the highest need, to enable more effective preventative care and early intervention. There is clearly a need for more research to provide a robust evidence base for the development of mandated patient pathways through NICE guidance/commissioner specifications.

The RCPod also welcomes the plan’s commitment to increase digitisation within the NHS. There is significant potential for digital tools to transform podiatric care. Digitisation can enable remote monitoring and early detection of foot problems. It can also support multidisciplinary working and integrated care pathways and empower patients to self-manage their conditions through digital education and support. However, for these benefits to be realised, it is essential that podiatry services have access to the necessary digital infrastructure, training, and resources. Investment in the integration of podiatry data into wider NHS systems is crucial to maximise the impact of digitisation on patient outcomes.

Despite these opportunities, the RCPod is deeply concerned about the workforce crisis facing the profession. NHS England has previously described podiatry as a profession ‘at high risk of failure’ due to a contracting workforce, and unsustainable and ever increasing pressures on clinicians. Without urgent action, there will be insufficient numbers of podiatrists to deliver the preventative care that is central to NHS England’s vision for a healthier population. The main workforce challenges are in recruitment and retention. The profession also struggles to attract new entrants, particularly in regions without undergraduate podiatry programmes. While the growth of apprenticeships is a positive development, it must not come at the expense of traditional undergraduate and pre-registration master’s programmes. Both routes are vital for ensuring a well-trained and diverse workforce.

To address these challenges, the RCPod calls on the government to improve funding for podiatry undergraduate education and training programmes, including both apprenticeships and traditional undergraduate degrees. There is a need for a clear national strategy for recruitment and retention, with targeted incentives for working in underserved areas, specifically rural and coastal areas. Supporting cross-sector placements and the development of new education programmes in regions of need will also be critical for building a resilient workforce.

The RCPod supports the plan’s ambition to break down barriers between primary care, community care, and acute services. Podiatrists are already at the forefront of integrated care, working alongside GPs, nurses, and other allied health professionals to deliver holistic, patient-centred services. Better integration of podiatry into care pathways will ensure early detection and intervention of foot and lower limb complications, reduce falls, keep people in work, and reduce duplication and inefficiency across the NHS. All this will reduce the burden on acute services. The RCPod urges the government to ensure that podiatry has a strong voice in the implementation of integrated care systems and that podiatry services are commissioned in all relevant disciplines. The RCPod advocates benchmarking the existing exemplar NHS podiatry providers who work across community and secondary care services, following the patient through their entire NHS podiatry pathway, breaking down barriers, supporting patient transition and improving outcomes, with an ambition of making this a consistent approach across NHS podiatry services.

The RCPod welcomes the plan’s aim of reaching patients earlier, and making the healthy choice, the easy choice. However, achieving this will require structural change and sustained investment, not just in acute services but in the workforce and community-based services that keep people healthy and independent. The RCPod looks forward to seeing more detail on how the plan will deliver primary, secondary, and tertiary prevention at scale, and stands ready to contribute its expertise to ensure these ambitions become reality.

We welcome the thriving young lives initiatives and would wish to see podiatrists included as part of the Allied Health Professions teams who initiate interventions for children. Specifically, podiatrists have a key role to play in reducing foot and lower limb pain and addressing gait anomalies, thereby enabling children to participate in physical activities, and helping to reduce obesity rates.

The integration of NHS England into the Department of Health and Social Care makes sense if the aim is to ensure a lack of duplication and maximise resources. However, our hope is that the important regional work that NHS England has been involved with continues. It is only through specific local knowledge of workforce and service delivery that the levers within government can effectively be pulled to enable improved quality service delivery.

As previously announced, Integrated Care Boards will be cut by 50% and Clinical Support Units will be abolished. However, there is no detail as to how those functions will be picked up, and which will be lost. Nor has there been any information on whether the remaining workforce will simply be expected to pick up the additional tasks. This is to say nothing of the 12,500 people who will be made redundant; the redundancy package is estimated to be between £600m and £1bn.

From a podiatry perspective, in order for the 10-year plan to be successful, the RCPod is launching two national campaigns. One to promote careers in podiatry and another to raise public awareness of the profession’s vital role in keeping people healthy, mobile, and active. These efforts are essential for attracting new talent to the profession, ensuring patients, GPs, other healthcare professionals and commissioners understand the value of podiatry, and the need to embed it at the heart of the NHS’s preventative model.

In conclusion, the RCPod broadly welcomes the government’s 10-year plan for the NHS and its focus on local delivery, prevention, and digitisation. However, to achieve these ambitions, the government must fully recognise and invest in the podiatry profession. This means addressing the workforce crisis through funding, education, and strategic recruitment; integrating podiatry into all levels of care to support early intervention and prevention; harnessing digital innovation to improve patient outcomes; tackling health inequalities by prioritising podiatry services in deprived areas; tapping in to the resource and expertise in independent practice; and ensuring the profession has a strong voice in the implementation of the plan. Podiatry stands ready to play a leading role in delivering a sustainable, effective, and equitable NHS for the next decade and beyond. The RCPod looks forward to working with government, NHS leaders and other stakeholders to ensure the profession’s unique potential is fully realised for the benefit of patients and communities across England.