Summary
The project was rolled out from June 2014 and diabetic foot services within Wakefield were redesigned to meet the challenge of reducing amputations and saving limbs. This included establishing a secondary care-based multi-disciplinary team (MDT) clinic Monday to Friday plus the creation of a community-based Diabetes Foot Protection Team (FPT) working across three community sites. The FPT sees all people who are medium risk and above, improving the management of the foot, providing patient education and information, advice and ensuring a prompt referral to the MDT as needed. The project identified that low risk patients could remain in primary care but the medium risk required referral into the FPT. This change in practice has resulted in earlier identification, earlier risk management and has expedited referral.
Challenge
The Diabetes Foot Project was needed to reduce the number of diabetes-related amputations. This would be achieved by preventing new active diabetes foot disease and allowing prompt referral and treatment if any new disease occurred, therefore reducing the risk of further complications and both major or minor amputation.
Objectives
To develop a community-based FPT working across three different locations in Wakefield and ensure that people with diabetes receive a correct foot assessment and risk stratification leading to them being seen by the right person at the right time. To reduce the time required in GP and practice nurse appointments and prevent the development of new foot disease by regular surveillance. To reduce diabetes-related amputations, improve quality of patient care and cut the number of follow-up appointments by earlier identification and treatment of new foot disease.
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