This partnership was launched to improve diabetes-related health outcomes across Lambeth and Southwark. It consists of patients, who noted inconsistencies in primary foot healthcare, HCPs and commissioners. Aims include providing patients with clear, consistent information about routine and specialist foot care, including self-management and improving the local foot health pathway and resources for patients and providers. Since work began in 2011/12, over 2,900 additional patients received an annual foot check, an increase of 14% by 2013/14.
Through the Diabetes Modernisation Initiative (DMI), a partnership – Lambeth and Southwark Diabetes Foot Health Group (LSDFHG) – was established, to address the recurrent challenge of diabetes foot health.
People with diabetes and their carers had been unsure of how to self-manage or access specialist care. Primary care providers were unclear about referring into specialist services, and found communication and processes inconsistent.
Specialist services suffered from poor communication, and where they operated across several sites, were unclear about differences in patient case-mix. No formalised arrangement existed between trusts for shared care or transfer to community podiatry.
Commissioners were concerned about the financial implications of current models. All stakeholders suffered from poor communication and a local failure to implement national best practice.
There were several objectives. Firstly, to provide people with diabetes with clear, consistent information about foot health and care access. Secondly, to give providers of diabetes-related foot care a defined local foot heath pathway.
Thirdly, the partnership aimed to work closely with commissioners to identify and support changes to resources, and to ensure patients are seen in the most appropriate care setting according to their risk and clinical condition, ideally closer to home in the community.
Finally, it aimed to identify, share and disseminate best practice from each sector to foster mutual learning and ongoing future improvements to the pathway.
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