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The Diabetic
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‘Legs Matter’ initiative

Paul Chadwick, Leanne Atkin
When we became aware there was going to be a campaign looking at ensuring best practice lower-limb care, we immediately made contact to ensure that the foot was recognised as a key part of the lower limb. This may sound obvious, but we know in reality that the foot often gets missed off when discussing the lower limb or else gets token recognition. The College of Podiatry and FDUK were keen to ensure that the foot remained central to the campaign and joined the coalition at its inception.

The ‘Legs Matter’ campaign was launched on April 25, 2018 to promote good quality care of the lower leg in the UK. Inspired by the ‘Stop the Pressure’ initiative, the Legs Matter campaign seeks to raise awareness and understanding of conditions of the lower leg and foot to ensure timely and effective care. In particular, it seeks to make the public more aware of conditions of the lower leg and foot, the importance of seeking out the right treatment in a timely manner and what care they have the right to expect from healthcare professionals. The campaign also aims to educate generalist healthcare professionals on the signs, seriousness and implications of lower leg and foot conditions, together with the importance of considering the lower leg and foot when assessing and treating patients.

The Legs Matter campaign is being delivered by a coalition that includes:

  • College of Podiatry (COP)
  • Foot in Diabetes UK (FDUK)
  • Tissue Viability Society (TVS)
  • Society of Vascular Nurses (SVN)
  • Lindsay Leg Club Foundation
  • British Lymphology Society (BLS)
  • Accelerate CIC
  • The Leg Ulcer Forum (LUF)

Together, the coalition has developed a website that offers high-quality, unbiased information for patients and clinicians. The website has been developed with patient and public involvement and covers a wide range of common conditions that affect the lower leg and foot. It provides evidenceinformed information and signposts to other robust and trustworthy sources of information. We hope that the Legs Matter campaign will resonate with the public and healthcare professionals who share our vision to increase awareness of lower-limb conditions to reshape and improve care together.

What has Legs Matter achieved since its inception and what are the ongoing projects at the moment? We have created a website that we hope will be the ‘go to’ information site for patients and one which healthcare professionals direct their patients to. The website has been developed by the coalition members with the direct involvement of three patient experts, who have now joined the board to ensure we have true patient involvement. We are all committed to ensuring that the patients have equal voice on the board, as we recognise this website is for them, so in fact they are the experts.  The group has had a high visibility at many national conferences and was nominated as charity of the year by our sister publication Wounds UK.

The Legs Matter campaign is ultimately a patient’s awareness campaign, so no matter what your profession/role, we would love you to help share our messages by directing patients to a resource where they can learn more about their condition, read accurate information and better understand their own conditions. Additionally, in the next few months we will be creating new web pages on the site where patients will be able to gain hints and tips and living with their condition, about what to expect and how to cope with the changes in their lifestyle — these pages are being written by our patient members.

We have sent out over 200 information packs to nurses, clinics and GP services, which include posters for waiting rooms, business cards to give to patients with details of the website — these are free to all — just contact us via our website to receive your information pack. We are in the early stages of planning an awareness raising month and we hope to run this in early summer.

Every professional in the field of lower-limb conditions appreciates that regular patients have been let down by the service they have received, often resulting in delayed referrals to diabetic foot multidisciplinary teams and vascular centres, and a lack of evidence-based care. There is variation in commissioning and service set up nationally.

We need to ensure that all patients are empowered in relation to recognising what is good quality care and what should happen if they have a foot or leg problem. This will enable them to identify if the care they are receiving is not appropriate, signposting them on how to change this. This is something that no matter what your profession we all appreciate the need to address, ensuring that all patients’ suffering is minimised by appropriate management linked to best evidence. By supporting this campaign through raising its awareness, you will be helping to inform/empower patients with the hope that a strong patient voice will ensure care is timely, appropriate and effective. So please help us spread the word.

REFERENCES:

Ashby RL, Gabe R, Ali S, Adderley U (2014) Clinical and costeffectiveness of compression hosiery versus compression bandages in treatment of venous leg ulcers (Venous leg Ulcer Study IV, VenUS IV): a randomised controlled trial. Lancet 383(9920): 871–9

Franks P, McCullagh L, Moffat L, Moffatt C (2003) Assessing quality of life in patients with chronic leg ulceration using the Medical Outcomes Short Form-36 questionnaire. Ostomy Wound Manage 49(2): 26–37

Guest JF, Ayoub N, McIlwraith T et al (2015) Health economic burden that wounds impose on the National Health Service in the UK. BMJ Open 5(12): e009283

Guest JF, Ayoub N, McIlwraith T et al (2017) Health economic burden that different wound types impose on the UK’s National Health Service. Int Wound J 14(2): 322–30

Moffatt C, McCullough L, O’Connor T (2003) Randomized trial of four-layer and two-layer bandage systems in the management of chronic venous ulceration. Wound Repair Regen 11(3): 166–71

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