A new Diabetes UK report, Fast Track For A Foot Attack: Reducing Amputations, warns that too many areas do not have the systems in place to ensure foot ulcers and foot infections in people with diabetes are treated within 24 hours. This is despite the fact that ulcers can deteriorate extremely quickly and a matter of hours can make the difference between keeping a foot and losing it.
It has highlighted the lack of these systems at a local level as one of the main reasons the number of foot amputations is increasing – there are already 6000 diabetes-related amputations each year and this is projected rise to 7000 by 2015. It is thought that up to 80% of these amputations could be prevented.
The report, which Diabetes UK has produced with the Society for Chiropodists and Podiatrists and NHS Diabetes, makes recommendations that could dramatically reduce diabetes-related amputation rates and bring an end to the current situation where people with the condition are over 20 times more likely to have an amputation than the rest of the population
The recommendations include:
- All hospitals should have a multidisciplinary footcare team. NICE recommends that these teams should be in place, but the most recent figures suggest 40% of hospitals do not have them.
- Every hospital should guarantee that people with urgent foot problems can be assessed by a multidisciplinary footcare team within 24 hours, as it is vital that foot problems are treated quickly.
- Every area should have a system for identifying and regularly reviewing people at high risk of foot ulcers and infections , including annual foot checks and foot protection teams in the community.
- People with diabetes who are at high risk of foot problems should know what to look out for and where to go in the event of a foot problem.
Barbara Young, Chief Executive of Diabetes UK, said: “It is unacceptable that every single week people with diabetes who have treatable foot problems are having feet or toes amputated because they are not being treated quickly enough.
“It is not as if this is a problem we don’t know how to solve. If every hospital had a multidisciplinary footcare team and ensured access to that team within 24 hours, then that would make a huge difference to the amputation rates. We also need to make sure people with diabetes are getting a thorough annual foot check and then those at high risk of amputation are given the help they need to prevent them. All too often, we hear stories about foot checks that are so fleeting that the person is not even asked to take their shoes off.
“This is not something that requires more money. In fact, putting these kind of systems in place can actually save money because the amputations that they prevent are so expensive. But we need leaders across the NHS, the NHS Commissioning Board and local clinical commissioning groups, to insist that this happens and hold those areas that do not have these systems in place to account. We need action now.”
The report can be downloaded from www.diabetes.org.uk/Documents/Reports/putting-feet-first-foot-attack-report022013.pdf.
