New team leads to huge improvements in Trust’s diabetes service
Huge improvements have been made to the diabetes service at the Trust, which runs the county’s acute hospitals, after an in-house team was recruited.
The creation of the team, which is made up of four podiatrists, at The Shrewsbury and Telford Hospital NHS Trust (SaTH) has already been deemed a success with them seeing more inpatients and sooner.
National figures show that 14-24% of people with a diabetic foot ulcer will require amputation with NHSE estimating that 85% of the diabetic feet amputations are preventable. Diabetic foot care costs the NHS £1 billion per year.
Various measures have been introduced since the creation of the team, which operates at Royal Shrewsbury Hospital and Princess Royal Hospital in Telford, to improve care, improve referral to the service and allow quicker access for patients.
They include:
- Improving the number of inpatients having a compulsory foot check. Within six months this has gone from 10% of patients to 60% of patients having checks.
- Compulsory education for ward staff. It is more tailored and made simpler for their circumstances.
- Design of the Achiles Tool, which is a mirror on one side and guidance on the other. A protocol is now in place for staff, making it easier to understand and it concentrates on prevention rather than cure. It also helps signpost when there is an acute problem.
- Hot clinic with the Emergency Department (ED). If anybody comes to hospital with a diabetic foot ulcer and is not admitted to hospital, they now have fast access to a walk-in slot the next working day. Previously they would attend ED and be referred to their GP. They would then have to wait for a GP appointment.
- Hotline. All patients even if discharged are given the team’s phone number and they can refer back in at any time – it is all about quick access.
- Outpatients are now seen sooner than ever by a multidisciplinary team, this has been shown by the national diabetic foot audit to be the intervention that heals wounds quicker.
Nicky Beard, Podiatry Diabetes Lead, at SaTH said: “Our staff are very passionate about diabetes foot care and want to ensure our patients get gold standard treatment. This is a level of care that we haven’t been able to provide before.”
Anna Green, Clinical Director for Diabetes, said: “Nicky has done an amazing piece of work. The care is improving and processes are easier. The team is available if anyone has problems. There is protection for every person coming in to prevent them getting heel pressure sores too.
“Having our own team means we can recognise the needs of our patients and adapt our service to them in a prompt and efficient manner. We can train our team and the new system creates freedom and flexibility.”
Paula Gardner, Chief Nursing Officer, said: “The progress that has been made to the Trust’s diabetes service has been remarkable with the creation of the in-house team. They are a phenomenal team who are striving to improve the care for our patients.”
Nicky said: “The NHS 10-year plan going forward is all about prevention rather than cure. We need to work alongside the community and Primary Care to ensure people have the correct pathways to avoid amputation.”
Anna added: “As the podiatrists are in-house, they will each take a lead role in the developing part of the service and instrumental in developing the service further. They will be moving beyond just seeing the patient and doing work in the clinics.”
Nicky and the team are also looking to spread the word and develop educational events for all staff across the system – SaTH, Primary Care and the community.
