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New diabetic foot pathway from NHS England

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The pathway is designed to prevent complications The pathway is designed to prevent complications on the feet

A new framework to improve care for people with diabetic foot has been published by NHS England.

The report covers recommendations across commissioning, service design, screening, protection, multi-disciplinary foot care service, outpatient management of diabetic foot complications and training.

‘If we can ensure patients with diabetes have the appropriate, high-quality care they deserve across the country then we can prevent amputations,’ said Professor Jonathan Valabhji, NHS England’s national clinical director for diabetes and obesity.

‘There are several steps we can take to ensure this happens, one of which is to ensure that those presenting with active diabetic foot disease have rapid access to a multidisciplinary diabetic foot service. Higher mortality rates are thought to be related to heart disease and therefore we also need to ensure the all-round health of the patient is cared for, including addressing their overall cardiovascular disease risk,’ he added.

The recommendations say commissioners should make sure all patients with diabetic foot problems have rapid and equal access to services, regardless of location, in order to optimise care and reduce amputation rates.

They describe the key systems, processes and standards needing to be in place to achieve this goal.

Professor Valabhji worked with a number of key organisations to produce the report including: the British Orthopaedic Association, the British Orthopaedic Foot and Ankle Society, the Vascular Society, Diabetes UK, the Association of British Clinical Diabetologists, Foot in Diabetes UK; and the British Association of Prosthetists and Orthotists.

Foot complications are common in people with diabetes with between 5% and 7% of patients having current or previous foot ulceration.

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