Health-care professionals and service users who are dedicated to improving foot care for patients with diabetes across Scotland. It is chaired by a consultant in Diabetes (Graham Leese), and there is a seconded National Co-ordinator (Duncan Stang) who is a specialist podiatrist as well a part-time administrator.
Aims and objectives
· Identify Specialist Foot Services Available in Scotland
· Support development of Local “Foot” Networks
· Record Foot Screening: 75% of all patients in Scotland by 2009
· Develop consistent patient information nationally
· Accredit training programmes to recognise specialist skills Other adopted targets include;
· linking with out of hours services
· Improving the provision orthotic services for people with diabetes throughout the country
CPR for Diabetic feet
The Scottish Diabetes Foot Action Group (SDFAG) is currently working on a National initiative called CPR for Diabetic feet. This initiative is to try and make sure all patients with Diabetes who are admitted to hospital have their feet Checked on admission, if they are at risk of developing a foot ulcer their feet are Protected and if they have a current foot ulcer they are Referred appropriately. This is a simple concept to try and address a problem which was highlighted following an audit of 1,048 in-patients with diabetes which showed that:
· 2.4% of in patients with diabetes developed a new foot lesion whilst in hospital
· 57% of in patients had not had their feet checked
· 60% who were discovered to be at risk of developing a foot ulcer did not have any pressure relief in place
(Scottish Diabetes Foot Action Group 2013)
A LearnPro module is available to support this initiative and can be found at nhs.learnprouk.com and is under the CPD section.
· We are currently trying to define a framework for optimal service provision and map how each MCN area around the country is managing to achieve this
· Information regarding service provision in each MCN area is currently being collected and the mapping process is underway
· So far 40% of patients in Scotland have a foot risk score recorded. This has increased from 25% last summer.
· We now have Nationally agreed patient leaflets (n=6), a risk stratification and triage system, a training DVD and a training booklet. All are being distributed across Scotland, and we hope to have them on SCI-DC network soon
· Work for this is currently underway with UK groups
· We are currently collecting emergency telephone numbers for each MCN are around the country. So far 50% of MCNs have supplied us with these emergency contact numbers that can be given to NHS 24. This will allow patients to know who to call at 9am the following morning for advice/treatment
· We are working on developing core competencies so that podiatrists and orthotists specialising in diabetes can be recognised.
· The SDG has provided funding for each MCN to support links between podiatrists in the community and podiatrists in specialist diabetes centres.
· Defining desirable service specification, and targeting MCNs who need the most help, to develop resources and podiatry networks.
· Continue to encourage the good practice of foot risk stratification and support MCN’s to carry this out, especially those with the lowest rates.
· Establish “road-shows” in each MCN, to raise profile of foot issues, and demonstrate the educational resources available.
· To try and develop community link podiatrists in each MCN, and ongoing training opportunities for these individuals.
· Defining core competencies for diabetes specialism in podiatry and orthotics. An open and collaborative consultation to address all these issues is in the planning stages and will take place in 2010.
· Once the inner diabetes and MCN communities are aware of the developments and needs in diabetes foot disease, we need to persuade HB managers of the need to invest in these areas, on the back of the efficiency improvements we will have implemented.
· We are working towards an integrated diabetes footcare service.
The group includes consultants with an interest in diabetes foot Services from across Scotland, Podiatry Specialists in Diabetes, Orthotists with interests in Diabetes and Service Users. We have not been able to get practice nurse or GPs included so far.