1. Turning the Corner in Diabetes Care Maria Mousley AHP Consultant Podiatrist Northamptonshire tPCT Maria Mousley AHP Consultant Podiatrist Northamptonshire tPCT

2. Agenda Background National policy Aims and objectives Local practice National examples Opportunities and Challenges Background National policy Aims and objectives Local practice National examples Opportunities and Challenges

3. Background to Diabetes and Foot Disease increases chance of hospital admission five-fold most common cause of non-traumatic lower limb amputation 15% develop foot ulcers and 5-15% of those need amputations every 30 seconds a leg is lost to diabetes somewhere in the world increases chance of hospital admission five-fold most common cause of non-traumatic lower limb amputation 15% develop foot ulcers and 5-15% of those need amputations every 30 seconds a leg is lost to diabetes somewhere in the world Diabetes Key Facts, Yorkshire & Humber Public Health Observatory, March 2006

4. National Policy National Service Framework Standards 7 & 8 Long term conditions Our Health, Our Care, Our Say National Service Framework Standards 7 & 8 Long term conditions Our Health, Our Care, Our Say

5. Aims of the Diabetes in-patient project To support the development, review and communication of best practice in in- patient diabetes care…………….and to promote spread of these service improvements.

6. Objectives Collate information and evidence of current in-patient care and communicate this to local diabetes communities etc. Facilitate coordination and collaboration of service improvement Support research to demonstrate the efficacy of improvements Review development activity Collate information and evidence of current in-patient care and communicate this to local diabetes communities etc. Facilitate coordination and collaboration of service improvement Support research to demonstrate the efficacy of improvements Review development activity

7. Multi- disciplinary team Specialist team Community Chronic disease management DOH 2004 Pyramid of Care High risk patients At risk patients Ulcerated patients level of care

8. Local Practice – Northampton in-patient podiatry provision Integrated ward rounds Independent ward rounds Tissue viability focus Protected clinic time for in-patient provision Liaison with other AHP services Integrated ward rounds Independent ward rounds Tissue viability focus Protected clinic time for in-patient provision Liaison with other AHP services

9. Table 1

10. Other national examples Diabetic Foot Practitioner Tissue Viability Podiatrist Joint Diabetes Nurse Specialists and Podiatry visits to in-patient wards Diabetic Foot Practitioner Tissue Viability Podiatrist Joint Diabetes Nurse Specialists and Podiatry visits to in-patient wards

11. Opportunities and Challenges Practice based commissioning Workforce development and competence Payment by results Patient choice Practice based commissioning Workforce development and competence Payment by results Patient choice

12. ANY QUESTIONS?