Evidence of foot problems

1. Evidence of foot problems All patients should be referred, on diagnosis of diabetes, to podiatry for an initial assessment then on-going follow up as below. If this is not happening please arrange YES NO Are any of these present? ♦ New ulceration ♦ Known ulceration with cellulites or infection ♦ Known ulceration with deterioration in condition ♦ Suspected osteomyelitis/ulcer probing to bone ♦ Suspected acute Charcot foot ♦ Critical limb ischaemia, necrosisor gangrene Are any of these present? ♦ Neglected feet ♦ Corns or Callus ♦ Toe nail problems* ♦ Peripheral vascular disease ♦ Peripheral neuropathy ♦ Structural foot deformity ♦ Painful feet/abnormal sensations Patients at low risk of foot ulceration should receive annual foot checks provided by their GP practice Patients at high risk of foot ulceration should receive foot checks every 1-3 months provided by podiatry Patients at increased risk of foot ulceration should receivefoot checks every 6 months provided by podiatry Refer to Community Podiatry clinic listing patient’s current foot problem. Patient will be contacted for appropriate appointment (18 week RTT, 13 week av wait) Refer to Hotline for urgent podiatry appointment 01579 373550 Triaged phone line 5 days a week, office hours Cornwall & IoSDiabetic foot check & referral pathway Jan 2014 Contact with patient with diabetes. Inspect feet-remove patients’ shoes, socks and any dressings * diabetic patients do not automatically qualify for routine toe nail cutting District hot foot clinic (access within 72 hours max )–specialist podiatrist in 1of 3 area centres with informal access to M.D.T. Emergency admission Specialist podiatry clinic at RCHT (access within 72 hours max) with informal access to M.D.T. Diabetic foot clinic weekly M.D.T @RCHT to stabilise & prevent emergency foot