Diabetic Foot Care: Minimising the Risk and Helping the NHS

1st May 2020 Clinical Negligence

According to NHS data there are approximately four million people living with diabetes in the UK. It goes without saying that a significant proportion of those will develop a foot ulcer at some point.  Foot care is vital for patients suffering with diabetes.  I have seen a number of cases in my professional career where poor care and attention to this area has led to catastrophic outcomes, such as amputation.  In the most extreme cases I have seen, amputations have occurred to above and below the knee.   

Every Diabetologist and Physician I have spoken to has been an advocate of prevention not cure.  This has to be the sensible way forward.  Whilst many NHS Trusts now have effective systems in place such as a diabetic foot care pathway, it is vital that people are able to access these with ease and the patients do not get “lost in the system”. The cost of an amputation to the NHS is huge. A report published by NHS Diabetes states that £650 million is spent on foot ulcers or amputations each year, alone.  The increase in diabetes in the UK can only mean that this figure will continue to increase if allowed to go unchecked.  The numbers are simply unsustainable. 

As we know the NHS is stretched and has been for some time. In the current climate, with Covid-19, it’s important first and foremost to recognise the amazing work that doctors, nurses and healthcare workers are doing on a daily basis, over and above their day- to-day job.  Their commitment to patient care and patient safety is unrivalled. In addition however, patients should continue to attend to their usual care regime and where unable to do, contact their foot care liaison or GP for further advice. 

The NHS has published guidance which can be accessed here https://www.nhs.uk/live-well/healthy-body/foot-care-diabetics/, which includes the following helpful advice:

  • Keep your feet clean and free from infection.
  • Wear shoes that fit well and don't squeeze or rub. Ill-fitting shoes can cause corns and callusesulcers and nail problems.
  • Never walk barefoot in order to avoid cuts and try to avoid sitting with your legs crossed so you don't constrict your blood circulation.
  • Cut or file your toenails regularly.
  • Get corns or hard skin treated by a podiatrist, when possible. 

Whilst it’s difficult of course not to focus solely on the consequences of Covid-19, we can all help the NHS by adhering to the guidance issued to patients living with diabetes.       

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Mark Havenhand is a Partner located in Manchesterin our Clinical Negligence department

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