1. Cornwall & IoS Diabetic foot check & referral pathway Dec 2017
Contact with patient with diabetes. Inspect feet- remove patients’ shoes, socks and any dressings
Evidence of foot problems
YES NO
Are any of these present? ♦
New ulceration
Known
ulceration with cellulites or infection
Known ulceration with
deterioration in condition
Suspected osteomyelitis/ulcer probing to bone
Suspected acute Charcot foot
Critical limb ischaemia, necrosis or gangrene
Neglected feet
Corns or Callus
Toe nail problems*
Peripheral vascular disease
Peripheral neuropathy
Structural foot deformity
Painful feet/abnormal sensations
All patients should be referred, on diagnosis of diabetes, to podiatry for an initial assessment then on-going follow up as below If this is not happening please arrange
Patients at low risk of foot ulceration should receive
annual foot checks provided by their GP practice
Patients at high risk of foot ulceration should receive foot checks every 1-3 months provided by podiatry
Patients at increased risk of foot ulceration should receive foot checks every 6 months provided by podiatry
Refer for urgent podiatry appointment
Triaged phone & 5 days a week, office hours
Refer to Community Podiatry clinic listing patient’s current foot problem.
Patient will be contacted for appropriate appointment (18 week RTT, 13 week av wait)
* diabetic patients do not automatically qualify for routine toe nail cutting
District hot foot clinic (access within 72 hours max )–specialist podiatrist in 1of 3 area centres with informal access to M.D.T.
Emergency admission
Specialist podiatry clinic at RCHT (access within 72 hours max) with informal access to M.D.T.
Diabetic foot clinic weekly to stabilise & prevent emergency foot