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

Tota

l Site

s

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 o

f Ses

sion

s re

porte

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 Site

s

no yes0

2

4

6

8

10

12

Is there a dedicted MDT clinic?

Num

ber o

f SIte

s

Multidisciplinary Teams

0

2

4

6

8

10

12

14

16

Members of the MDTs

Podi

atri

stD

iabe

tolo

gist

Dia

bete

s Spe

cial

ist N

urse

Vas

cula

r Su

rgeo

n

Vas

cula

r Sp

ecia

list N

urse

Ort

hopa

edic

Sur

-

geon

Mic

robi

olog

istIn

fect

ious

Dise

ases

Tiss

ue V

iabi

lity

Nur

sePl

astic

Sur

geon

Oth

er

Num

ber

of S

ites

0

2

4

6

8

10

12

14

16

Diab

etol

ogist

Diab

etes

Spec

ialis

t Nur

seVa

scul

ar Su

rgeo

nVa

scul

ar Sp

ecia

list N

urse

Orth

opae

dic S

urge

on

Micr

obio

logi

stIn

fecti

ous D

iseas

esTi

ssue

Via

bilit

y Nur

se

Plas

tic Su

rgeo

n

Othe

r (de

rmat

olog

y ,

Pod

iatri

ic su

rger

y)

Radi

olog

istRe

nal P

hysic

ian

Num

ber o

f Site

s

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 S

hoe

Dar

co Sh

oe 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 Site

s

no yes0

2

4

6

8

10

12

14

16

Is an orthotist available in the podiatry clinic?

Num

ber o

f Site

s

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 Site

s

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.