Jessica Rees and Gaynor Slocombe
Cwm Taf University Health Board
NICE NG19 (2019) recommend that any person admitted with or because of acute diabetic foot problem should be referred to MDFT within 24 hours of admission and should be responded to within 24 -48 hours. Despite evidence of the risk of admission and the morbidity associated with diabetic foot ulceration (NDFA, NADIA) and recommendations for specialist podiatry to intervene early, evidence suggests that only one third of these patients with DFU at the time of admission have a foot examination within 24 hours of admission (NHS Digital 2017).
In response to lack of service provision, we secured fixed term funding via VBHC for an Inpatient Advanced Podiatry Coordinator in Royal Glamorgan Hospital (RGH) and are successfully
-achieving inpatient podiatrist review for 80% of patients with active diabetic foot ulceration within 1 working day as per guidelines.
-providing urgent podiatry assessment and intervention for acute diabetic foot disease presentation at ED/AECU and coordinating MDT management.
-providing education to ward staff to risk assess inpatients with diabetes, enabling timely and appropriate referral and management, improving coordination within the MDT, reducing morbidity
-Aiming to capture improved patient outcomes and experience by coordinating MDT management of acute diabetic foot disease and reduce length of stay
The primary site (RGH) will continue with ongoing clinical requirements and data collection along with staff training. VBHC team involved will aid with evaluation development (Aug-Sept), re-engage with stakeholders (Oct-Dec), business Case development (Oct-Dec) and share project outcomes at conferences and meetings.
During the 12 months we would continue with current VBHC project by delivering a dedicated in-patient podiatry service at RGH and continue to collect the data to ensure our practice is evidence based.
If implemented at remaining 2 DGH sites, will follow same pathway as initial pilot by including discussion with relevant stakeholders, sharing information on referral pathway/criteria and repeat comparative data collection.
Jessica Rees
Gaynor Slocombe
