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.