Put feet first and prevent unnecessary amputations


Foot Injury Amputation DiabetesPeople with diabetes are over 20 times more likely to have an amputation than the rest of the population.

Each week in England there are around 120 amputations in people with diabetes and it is estimated that by 2015, the number of diabetes-related amputations is expected to rise to 7,000 a year.

The majority of diabetes-related amputations in the UK are as a result of a foot ulcer or infection failing to heal. Shockingly, it has been found that most of these amputations are preventable, and a recent study by Kerr has found that amputations have been reduced by over 50% where hospitals have introduced multidisciplinary foot care teams. Yet despite national guidelines recommending that these teams should be in place, recent figures suggested 40% of hospitals do not have them.

Therefore, leading charity, Diabetes UK has called for action to be taken by the NHS Commissioning Board, Clinical Commissioning Groups (CCGs) and Health and Wellbeing Boards as people with diabetes who have treatable foot problems are having feet or toes amputated because they are not being treated quickly enough.

Diabetes UK, the Society for Chiropodists and Podiatrists and NHS Diabetes have collaborated to produce a report, called Fast Track For A Foot Attack: Reducing Amputations. This report warns that too many areas do not have the necessary systems in place to ensure that diabetic foot ulcers and foot infections are treated within 24 hours. Even though it is well known that ulcers can deteriorate extremely quickly and a matter of hours can make the difference between keeping a foot and losing it.

The report makes recommendation that could prevent unnecessary amputations:

  • All hospitals should have a multi-disciplinary foot care team (MDT).
  • Every hospital should guarantee that people with urgent foot problems can be assessed by an MDT within 24 hours because ulcers can deteriorate extremely quickly and a matter of hours can make the difference between keeping a foot and losing it
  • Every area should have a system for identifying and regularly reviewing people at high risk of foot ulcers and infections, including annual foot checks and foot protection teams in the community
  • People with diabetes who are at high risk of foot problems should know what to look out for and where to go in the event of a foot attack

Barbara Young, chief executive of Diabetes UK, has said that "this is not something that requires more money," she continued "In fact, putting these kinds of systems in place can actually save money because the amputations that they prevent are so expensive."

This article was written by Helen Donaghy, Medical Negligence Team.

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