1. Personal Footcare Education Programme Sections 1- 5 Developed by the Scottish Government Personal Footcare Working Group, January 2013. With acknowledgment for the content of these slides to the Podiatry Services of NHS Dumfries & Galloway, NHS Lothian and Cardiff and Vale University Health Board.

2. Content of the Programme This education programme contains 8 sections:  Section 1: What is personal footcare  Section 2: Keeping feet clean  Section 3: Skin care and checking feet  Section 4: Footwear  Section 5: What to do if you spot a problem  Section 6: Nail cutting and filing  Section 7: Nail conditions  Section 8: Frequently Asked Questions (FAQs)

3. Learning Outcomes By the end of this programme you should be able to:  Explain the importance of good personal footcare  Clip and file toe nails safely  Recognise why feet need to be checked on a regular basis  Explain the importance of good skin care  Describe the correct features of good fitting footwear  Be aware of the referral criteria/pathway to their local NHS podiatry service and recognise when to make a referral

4. Section 1: What is Personal Footcare Personal footcare is the term used for what a healthy adult would normally do for themselves for their feet if they are able to. It includes;  Keeping feet clean  Skin care  Checking that feet are in good order  Keeping toenails at a good length  Choosing good fitting footwear  Getting help if you spot a problem

5. A personal footcare toolkit  Nail clippers or nippers  Nail file or emery board  Plasters  Skin wipes  Moisturising cream  Surgical spirit

6. Exclusions Poor blood supply Poor blood supply Poor sensation - numbness Poor sensation - numbness Medication e.g. anticoagulants, steroids, chemotherapy Medication e.g. anticoagulants, steroids, chemotherapy Diabetes – screened as high risk Diabetes – screened as high risk Rheumatoid Arthritis – unless assessed as suitable Rheumatoid Arthritis – unless assessed as suitable Certain skin and nail conditions where there is inflammation, discharge or pain Certain skin and nail conditions where there is inflammation, discharge or pain Severe swelling of the feet and toes Severe swelling of the feet and toes

7. Section 2: Keeping feet clean  Wash feet daily in warm water  Use a soft brush  Don’t soak for too long - no more than 10 minutes  Pat gently dry  Use cotton pads or buds to dry gently between the toes

8. Section 3: Skin Care and Checking Feet  Keep feet clean  Apply moisturiser if skin is dry  Check in between toes  Apply surgical spirit between toes is skin is moist  Check heels for pressure damage Images courtesy of NHS Lothian

9. Common skin conditions Images courtesy of NHS Lothian corns hard skin - callus

10. Dry (Anhydrotic skin) Cracked heels/fissures Dry skin

11. Moist Skin  Hyperidrosis  Athletes foot

12. Section 4: Footwear  Wear well fitting shoes, a foot shaped shoe!  Round toed shoes with good depth  Avoid synthetic materials  Your shoe should support your foot  Laces, Velcro, Buckles.

13. Check footwear for fit

14. Slippers  Occasional wear  Straps/velcro  Sturdy sole

15. Sloppy Slippers

16. Section 5: What to do if you spot a problem Signs of infection  Pain  Swelling  Heat  Redness  Pus and blood may also be present Images courtesy of NHS Lothian

17. High risk foot Images courtesy of Cardiff & Vale USB Podiatry Service

18. Neglected nails Image courtesy of NHS Lothian