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Foot health

Why is the programme required?
There is significant variation in the rate of diabetic foot amputations in East Midlands. Around 80% of foot amputations in people with diabetes are preventable. This will require improvements in foot care within primary, community and secondary care.

Within East Midlands a number of clinical commissioning groups have seen a decrease in both major and minor amputations and amputation rates. A larger number of clinical commissioning groups are seeing a decrease in major amputations whilst minor amputations are increasing. However, there are a number of clinical commissioning groups that are showing a significant increase in both major and minor amputations.

It is important that clinical commissioning groups look at what is happening with the number of amputations and not just the amputation rate and also take account of changes in the diabetic population over this period. Whilst clinical commissioning groups may have amputation rates below the national average an increase in the number of major and/or minor amputations and/or amputation rate should be of concern.

How have we made a difference?
We have:

  • offered clinical commissioning groups the opportunity of having a supportive peer review visit of diabetic foot care pathway within clinical commissioning groups either with highest or increasing numbers of foot amputation rates.
  • completed a review with providers and Mansfield & Ashfield Clinical Commissioning Group and Newark & Sherwood Clinical Commissioning Group, and clinical commissioning groups in South Nottinghamshire. This has provided an in depth review of the current pathway and recommendations for action to address gaps.
  • produced comparative information for clinical commissioning groups to highlight trends and variation in foot amputation rates.
  • developed competency framework for primary care and community staff undertaking diabetic foot risk assessment. We strongly recommend the need for face to face training of staff in primary care undertaking foot risk assessments.
  • developed standardised information leaflets for patients (low, moderate and high) with input from East Midlands Diabetic Foot Care Network to inform diabetic patients of their level of risk. Leaflets are to be made available to patients through podiatric and primary care services.
Diabetic Foot Amputations
The foot amputation infographics pulls together information on foot amputations and episodes of hospital care related to diabetes foot care by Clinical Commissioning Group. The infographic compare the number of amputations and amputation rate per 1,000 diabetic patients over the 3 year periods from 2009-12 to 2012-15. The information is taken from Diabetic Foot Care Profiles produced by Public Health England. Public Health England also provided an annual breakdown on number of amputations over the last 3 year period.

pdfCorby CCG Diabetic Foot Amputation Infographic
pdfEast Leicestershire and Rutland Diabetic Foot Amuptation Infographic
pdfErewash CCG Diabetic Foot Amuptation Infographic
pdfHardwick CCG Diabetic Foot Amputation Infographic
pdfLeicester City CCG Diabetic Foot Amputation Infographic
pdfLincolnshire East CCG Diabetic Foot Amputation Infographic
pdfLincolnshire West CCG Diabetic Foot Amputation Infographic
pdfMansfield and Ashfield CCG Diabetic Foot Amputation Infographic
pdfNene CCG Diabetic Foot Amputation Infographic
pdfNewark and Sherwood CCG Diabetic Foot Amputation Infographic
pdfNorth Derbyshire CCG Diabetic Foot Amputation Infographic
pdfNottingham City CCG Diabetic Foot Amputation Infographic
pdfNottingham North and East CCG Diabetic Foot Amputation Infographic
pdfNottingham West CCG Diabetic Foot Amputation Infographic
pdfRushcliffe CCG Diabetic Foot Amputation Inforgraphic
pdfSouthern Derbyshire CCG Diabetic Foot Amputation Infographic
pdfSouth Lincolnshire CCG Diabetic Foot Amputation Infographic
pdfSouth West Lincolnshire CCG Diabetic Foot Amputation Infographic
pdfWest Leicestershire CCG Diabetic Foot Amputation Infographic

Foot Health Leaflets for patients
pdfLow Risk Patient Leaflet
pdfModerate Risk Patient Leaflet
pdfHigh Risk Patient Leaflet

Who to contact for further information?

This email address is being protected from spambots. You need JavaScript enabled to view it., Senior Quality Improvement Lead