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Bevan Exemplar Cohort 2 Projects

Taking a STANCE on Patient Education

Angela Jones

Cardiff & Vale University Health Board


To provide foot health education and healthier lifestyle support to all patients with diabetes who are referred to podiatry.

The project was developed in partnership with patients and healthcare professionals: “My Healthy Feet” concentrates on diabetic foot health and foot pathology prevention. “Healthy Me” enables the patient to have the right knowledge and support to control their diabetes.


  • No structured delivery of foot health education or healthier lifestyle messages;
  • Informal education delivered at clinician’s discretion;
  • Increasing numbers of patients with diabetes challenging NHS constraints;
  • Increasing complex caseload of patients with diabetes who are at risk of developing foot ulceration; and,
  • Strategic Drivers: NICE (NG19) 2015, All Wales Diabetes Delivery Plan.


  • Provide structured education to people with diabetes; and,
  • Provide structured access to support networks that enable healthier lifestyle choices.


  • Increase patient knowledge and engagement in foot health;
  • Increase confidence to self-care; and,
  • Reduce dependency on podiatry for basic foot care.


  • STANCE education for “My Healthy Feet”;
  • Support directory of local services and training for staff to support “Healthy Me”;
  • Collaboration with Diabetes UK and Pocket Medic – bespoke diabetes education;
  • Delivery of one-hour diabetes education 2 weeks prior to 1-to-1 consultation;
  • Consultation to identify “My Healthy Feet” and/or “Healthy Me” concerns; and,
  • Provision of additional support/empowerment to self-care and access to help when needed.


  • Patient Focus Group: Co-development of group education session. What would patients like to know?
  • Swim Lane Method: To identify risk and inefficiencies for the care of patients with diabetes.
  • Plan, Do, Study, Act: To review methods, procedures, progress and outcomes.
  • Patient Reported Outcome Measures: Are we meeting the patient’s needs and expectations?


Patient Reported Score Before & After Diabetes Education: