1. Podiatric Surgery
Mike Townson

2. Background Previous commissioning interest Venue?
Care UK – Walk in Centre
Lower Limb Pathway
Persistence
Good data
Good recruitment
Integration

3. Service November 2010 155 procedures 1 theatre session
Lower limb assessment and follow up clinics

4. What has happened
Profile
Consultant led
Up skilling
Integration

5. Activity 13 Surgical Procedures 8 Injection Therapy Scarf & Akin
PIPJ Arthroplasty
Chielectomy
Amputation
Lapidus
Exostectomy
8 Injection Therapy

6. Orthopaedics Back log Injection midfood right Fusion ipj left 2nd toe
Fusion left hallux ? Removal of screws right hallux
Bilateral scarf/akin
Removal of toenail left hallux
TMTJ right fusion foot
Wedge excision nail bed left little toe
Orif non-union left metatarsal
Open debridement right talus
Scarf/akin left hallux
Excision MT head right 2nd toe
Lapidus right hallux
Excision right foot ganglion
Arthroscopic ankle fusion left

7. Primary OPCS Procedure Desc
HRG Code
HRG Desc GP
Age
LOS
Primary OPCS Procedure Desc
HB33B
INTERMEDIATE FOOT PROCEDURES FOR NON -TRAUMA CATEGORY 1 WITH CC 62 6
FUSION OF FIRST METATARSOPHALANGEAL JOINT NEC 67 3
HB32Z
INTERMEDIATE FOOT PROCEDURES FOR NON -TRAUMA CATEGORY 2 69 2
PRIMARY ARTHRODESIS AND INTERNAL FIXATION OF JOINT NEC 75
CUNEIFORM OSTEOTOMY PROX.PHALANX RESECT.HEAD FIRST METATARSA
HA31C
MAJOR FOOT PROCEDURES FOR TRAUMA WITHOUT CC 33
PRIMARY OPEN REDUCT/FRACTURE/LONG BONE/EXTRAMED/FIX USING PL 61 1
PRIMARY ARTHRODESIS AND EXTERNAL FIXATION OF JOINT NEC

8. Governance Medical Director Vascular Professor Medicines Committee
Strong process
Quality documentation
Transparent audit
Evidence of team training

9. Where next? All foot surgery has no value!? Whole time post
Develop team
Change pathway
Links to other services/pathways