New referral pathway for the Foot in Diabetes Caroline Leith Podiatry Team Leader I just want to say a few words about the new diabetic foot pathway The new mdft and in-pt diabetes care is currently being funded with money from our successful bid for a 2 year project funded by NHSE.

Benefits of new integrated diabetes service single point of access for referrals working in partnership with WHHT seamless care for pts increased MDFT clinic new podiatry / MDFT ward rounds This is an exciting time and the new pathways will bring benefits to our patients. The main benefits will be a single point of contact for referrers Working in partnership between with WHHT staff A seamless pathway for patients Much increased Multi disciplinary foot clinics And most exciting of all is that we have started in patient podiatry and MDFT ward rounds twice a week

Low Risk Adequate vascular supply No neuropathy May have light callus Do not refer to podiatry A reminder of the care pathways There is no change to the low risk pathway. These people do not need to see podiatry

Increased/Moderate Risk 1 risk factor present Neuropathy OR Ischaemia OR Deformity OR Other risk factors Only refer to podiatry if there is a foot care need The change to this pathway is that you should only refer moderate risk patients to Podiatry IF they have a foot care need. We do not need to see people just because they have a risk factor so your referral needs to make it clear what their foot problem is please.

High Risk More than one risk factor (eg neuropathy, ischaemia, deformity) Refer for podiatry These patients DO still need a referral

Ulcerated/Charcot Ulcer Infection Osteomyelitis? Red, hot foot Suspected Charcot Urgent referral to MDFT via HIDS This is the new and exciting part of the pathway. We now have MDFT clinics every day across Herts Valley. As I mentioned previously we also have in patient podiatry and MDFT ward rounds at WGH. These patients need referral within 24 hours. The new service aims to offer them an appt within a further 24 hours Patients who are medically unwell need admission

How to refer for Podiatry All diabetic foot referrals are to be sent via the electronic referral system to hv.diabetes@nhs.net All non diabetic foot referrals come directly to Podiatry at Sandridge Gate All diabteic foot referrals will go to the new diabetes email address and will then be allocated the appropriate clinic or MDFT appt The pathway for non diabetic Podiatry referrals remains unchanged