1. Podiatry, delivering care to people with diabetes?
Understanding variation and addressing challenges.
Alex Harrington M.Sc. B.Sc.
Clinical Lead Podiatrist
Acknowledge Irene M. Stratton M.Sc. FFPH
Honorary Associate Professor (University of Warwick Clinical Sciences Research Institute) Senior Statistician Gloucestershire Retinal Research Group

2. Understanding the Challenges and Identifying the variation

3. Understanding the burden of risk in Gloucestershire?
Can clinical information from primary care help identify those at risk of diabetic foot ulceration?
Applying the UKPDS neuropathy model

4. Struggling with capacity?
There is variation in the provision of service but generally providers employ between 5-10 WTE per 100,000 registered population, the average being 8.
12,912 podiatrists registered with the Health and care Professionals Council
The majority of the podiatry workforce is aged between years.
The average age of podiatry students on graduation is 32 years- the majority of whom are pursuing a second degree
If there is not an increase in student numbers the profession will be facing an enormous shortfall
References:
Farndon Lisa “A Demographic Evaluation of UK Podiatry Services” The Society of Chiropodists and Podiatrists 2016
NHS Benchmarking Network, Results of Benchmarking Community Services
National Institute for Health and Clinical Excellence (2015) Diabetic foot problems-prevention and management. NICE Guideline 19
NHS England (2015) The NHS Five Year Forward View.
The Society of Chiropodists and Podiatrists “Keeping the nation on its feet -Podiatry and Prevention”

5. Summary
• There is evidence to show improved and earlier access to podiatrists and podiatry services can improve outcomes
We need appropriately staffed NHS services that can provide comprehensive proactive preventative services rather that reactive podiatry care.
• Variation in care needs to be understood at a local level
• Patient education about diabetes and the risk to feet needs to be on a national scale
• The potential threat to bursaries for student podiatry places puts the future podiatry workforce and recruitment at significant risk