Post on 31-Mar-2015
London The Footcare Map
Richard Leigh
Working to improve Diabetes Footcare services in London
List of Hospitals (so far..)Thank you!
Central Middlesex HospitalCharring Cross Hospital Croydon University HospitalHomerton HospitalKing George HospitalKings College HospitalMile End HospitalNewham University HospitalNorth Middlesex HospitalNorthwick Park HospitalQueens HospitalRoyal Free HospitalRoyal London HospitalSt Helier HospitalWest Middlesex University HospitalWhipps Cross Unniverstiy Hospital
Out Patient Resources
Podiatry Chairs and Available Sessions (half days)
0 1 2 3 4 80
1
2
3
4
5
6
Number of Podiatry Chairs on Site
Total
Tot
al S
ites
Total podiatry chairs per site
0 1 2 3 4 5 6 7 8 90
10
20
30
40
50
60
70
80
90Total possible sessions per week
Num
ber
of S
essi
ons
rep
orte
d
Number of Podiatry Chairs
Maximum Capacity
Total Chairs 42 Total Sessions reported 278Total Sessions Possible (in a 5 day week) 400
Who is providing the service?
Community In house0
2
4
6
8
10
12
14
Podiatry Service Provider
Num
er o
f Si
tes
no yes0
2
4
6
8
10
12
Is there a dedicted MDT clinic?
Num
ber
of S
Ites
Multidisciplinary Teams
0
2
4
6
8
10
12
14
16
Members of the MDTs
Pod
iatr
ist
Dia
beto
logi
st
Dia
bete
s Sp
ecia
list
Nur
seV
ascu
lar
Surg
eon
Vas
cula
r Sp
ecia
list
Nur
se
Ort
hopa
edic
Sur
-
geon
Mic
robi
olog
ist
Infe
ctio
us D
isea
ses
Tis
sue
Via
bilit
y N
urse
Pla
stic
Sur
geon
Oth
er
Num
ber
of S
ites
0
2
4
6
8
10
12
14
16
Diab
etol
ogis
tDi
abet
es S
peci
alis
t Nur
seVa
scul
ar S
urge
onVa
scul
ar S
peci
alis
t Nur
seO
rtho
paed
ic S
urge
on
Mic
robi
olog
ist
Infe
ctiou
s Dis
ease
sTi
ssue
Via
bilit
y N
urse
Plas
tic S
urge
on
Oth
er (d
erm
atol
ogy
,
Pod
iatr
iic su
rger
y)
Radi
olog
ist
Rena
l Phy
sici
an
Num
ber o
f Sit
es
Who Else is Available to Podiatry outside the MDT?
Podiatry Facilities
Comment from two sites: Only specific Podiatrists have access to these results
0
2
4
6
8
10
12
14
16
Surg
ical
Sho
e D
arco
Sho
e D
erby
Boo
t
A
ircas
tPr
eval
on
(hee
l pro
tect
ors)
AFO
PRAF
O
Types of 'off the peg' orthosis available
Num
ber o
f Sit
es
no yes0
2
4
6
8
10
12
14
16
Is an orthotist available in the podiatry clinic?
Num
ber o
f Sit
es
Inpatient Resources
NHS Brent
NHS Barnet
NHS City and Hackney
NHS Croydon
NHS Hammersmith and Fulham
NHS Harrow
NHS Lambeth
NHS Newham
NHS Southwark
NHS Tower Hamlets
CCGs reported to have Foot Protection Teams by 16 Hospitals
no yes0
2
4
6
8
10
12
14
16
Do It systems link between hospital and community?
Num
ber o
f Sit
es
In Summary• 16 Hospitals have contributed to ‘the map’.
• There are 42 podiatry chairs in acute settings but 1/3 of the time they are not used.
• The majority of hospital podiatry is provided by the community service.
• Nearly 1/3 of hospitals have no foot MDT.
• The make up of MDT is various, but many hospitals have the right mix of HCPs but not necessarily in the same place at the same time.
• Only 2 hospitals have a radiology MDT.
• 2/3 hospitals have urgent access for GP patients.
• The majority of hospital podiatrists have access to tests/results.
• Casting is available in the majority of hospitals.
• Less than 1/2 hospitals have an orthotist available in clinic.
• Nearly all hospital podiatrists have access to offloading devices.
• Only 1/2 hospitals have an inpatient MDT which are limited in number of sessions.
• Topical negative pressure is available across most hospitals and community services.
• The 16 hospitals could only identify 10 CCGs with Foot Protection Teams.
• IT systems link 1/3 hospital to community services.