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Scrutiny Committee Scrutiny Committee Joan Twitchett Service - - PowerPoint PPT Presentation
Scrutiny Committee Scrutiny Committee Joan Twitchett Service - - PowerPoint PPT Presentation
Redbridge & Waltham Forest Podiatry Service Scrutiny Committee Scrutiny Committee Joan Twitchett Service Information Provides a service to the residents of Redbridge and Waltham Forest In community clinics across the districts
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Who is eligible for treatment
People who have a clinical or medical need Under 16 or over 65 Certain medical conditions Learning difficulties Physical conditions
that result in foot problems
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Podiatry Services available
Care for people in community clinics Education and assessment for people who require nail care
- r who have minor problems
Support for NSF for the elderly /Falls prevention Nail cutting for people with no carer support Multi disciplinary clinics in diabetes at hospital sites for
- utpatients and ward patients and domiciliary patients
Rheumatology and footwear clinics Bio mechanics Paediatrics In growing toenail surgery Care for socially excluded
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Benefits of joint service
One management structure One appointment centre Choice of appointments Emergency appointments
available across both districts
Cover available Broader range of experience Training and mentorship at
both hospital sites
Equity of care
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Achievements / Waiting Times
All referrals are triaged daily by a senior
Podiatrist .The department receives up to 170 new referrals per week
Emergency referrals(infection /ulceration) will be
contacted within 48 hours and offered an appointment within a week usually at either hospital site
People who have foot problems (corns callus)
and a medical problem(diabetes rheumatoid arthritis) are sent a letter inviting them to contact the department to arrange treatment, this will be 4-10 weeks following referral
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Low risk Referrals
People who are referred with minor foot
problems (long nails , corns , and calluses )
This group of people will be sent a letter within
a week of receipt of their referral inviting them to contact the department to arrange to attend an education and assessment session
Waiting time for education
and assessment is between 4-6 weeks
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Existing Patients
All existing patients and new people referred
to the service will be treated according to their clinical need
Waiting times vary from treatment weekly to an
appointment every six months depending on the type of foot problem
All patients are sent or given information
regarding the care of their feet and details of how to contact the service should they develop an emergency foot problem
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Domiciliary service re- design
The service has recently improved the service provided to
housebound people
All patients are now encouraged to phone in to arrange their
visits and are given a choice of times and dates / Reduced DNA rate
Senior specialist Podiatrists are carrying out holistic care for
people who would normally be asked to attend the hospital sites for treatment liasing with other health professionals where indicated
Appointments can be sent in the post if necessary Patients and carers are encouraged to carry out simple foot care
if possible , and will be given a foot file and moisturising cream to assist with this task
A nail cutting service is still available for people who are
housebound
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Current Challenges Referral rate increase
The number of referrals since
April 2004 has increased by 25% since the same period in 2003
In Waltham Forest 257 people were referred
requesting foot assessment for people with diabetes
565 of these people with diabetes had foot
problems In Redbridge and Waltham Forest there are approximately 14,000 people with diabetes 36%
- f these are of black and ethnic origin
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Effect on the Podiatry Service
Reduction in capacity for existing caseload Increase in people with severe foot problems Increase in workload for the office staff Waiting list for people requiring diabetic foot
assessment
Extra time required to provide education to
patients and other health professional
All Podiatrists require extra training Longer appointment time required
for more complex care
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Increase in Diabetic/general referrals Action taken
GMS requires that all diabetics have an annual health check this includes a foot assessment
A programme of education sessions has been
introduced
In house training for GPs can be arranged Multi disciplinary education sessions available for
with diabetes
Prioritising all other referrals for people with diabetes
- r other health problems and offering appropriate
care
Working with the local diabetes National Service
Framework implementation group
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Increase in the very elderly
The service has been working
with the falls prevention service in Redbridge and Waltham Forest
Education sessions can be
provided to nursing homes and carers groups
A small social nail cutting
service is available in community clinics. However this is an area of concern
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Diverse Population
Reaching all of the people who have the diabetes and offering education /or treatment
Attend local groups to provide education Working with the community health project
providing care for socially excluded people
Recently supported RESPECT week Access to translation service
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Recruitment of Podiatry Staff
Shortage of Podiatrist in the South East
Providing clinical placements
for the University of East London
Investigating recruiting abroad Have the facility of
accommodation at King George Hospital
In the future skill mix
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