Somerset leading the way in diabetic foot care

The report from Diabetes UK suggests that the NHS in England could save around £250 million by reducing foot ulcers across the country.

Somerset hospitals and GPs were able to save nearly £1 million by setting up a ‘diabetes foot pathway’ to give specialist help to people with diabetes more quickly.

A 24-hour referral system and specialist training for podiatrists, nurses and doctors caused major amputations in the county to drop by 43 per cent.

Preventing an estimated 19 amputations per year and reducing inpatient days for diabetes foot disease by 23 per cent saved approximately £926,000, almost six times the cost of improving the service.
 
The analysis, conducted for Diabetes UK, found that NHS trusts like Taunton and Somerset NHS Foundation Trust that rearranged or introduced specialist foot services - in hospital or the community – had improved prevention and treatment of foot problems for people with diabetes.

They reduced the number of ulcers, which can lead to the loss of a toe, foot or leg, and amputations, as well as making significant cost savings. 
 
The charity says that the overall savings resulting from such changes could amount to £250 million – a quarter of the £1 billion NHS England spends on diabetes foot care – and that it should be ploughed instead into improving treatment for people with foot ulcers.

For example, this sum would pay for the 7,000 podiatrists needed in England to ensure every person with diabetes received adequate specialist foot care.
 
However, the report found many people with diabetes in England are either having to wait a long time for specialist foot care or find the service doesn’t exist at all.

In many areas of the country there are no clear pathways for referral of patients to appropriate specialist services and nearly a third of hospitals do not have a multidisciplinary foot care team.

Almost two in three people with diabetes have no foot risk assessment during their hospital stay, despite this being recommended by NICE.

At least £1 in every £140 of NHS expenditure in England is spent on foot care for people with diabetes. Most of that money is spent on treating foot ulcers.

Diabetes UK south west regional head Phaedra Perry said: 
“There are more than 20 leg, foot or toe amputations each day and most of these result from a diabetic foot ulcer. Today, around 60-75,000 people with diabetes experience a foot ulcer. That’s roughly the same as the population of Taunton.
 
“NHS commissioners should be spending money treating ulcers rather than on managing their extreme consequences. Prompt treatment can prevent both the personal and economic cost of an amputation.
 
“It makes sense for NHS commissioners and budget-holders to invest now in effective foot care services, especially as the diabetes crisis facing the UK means an ever growing number of people are being diagnosed with the condition.”
 
Dr Julia Thomas, consultant physician and endocrinologist at Musgrove Park Hospital in Taunton, said: “Healthcare organisations from across Somerset came together to design an integrated diabetes foot pathway.

"This aimed to provide rapid access to specialist care and robust follow-up, and to eliminate inefficiencies.

"This has not only improved the quality of footcare for our patients but also has reduced costs to the NHS. Our goals are to reduce amputations further still and to ensure patients become experts in reducing their risk of developing foot ulcers.”