Diabetic Foot Care – helping commissioners and providers to achieve excellence High quality care for all, now and for future generations in the Thames Valley Dr Richard Croft, Diabetes Lead Thames Valley Strategic Clinical Network

We know this Each year in the UK, around 5,000 people with diabetes undergo leg, foot or toe amputations Foot problems can have a significant impact on a patient's quality of life. By reducing a patient's mobility these problems can lead to loss of employment and depression Up to £600m goes on treating diabetic foot problems, and at least £252m of this is spent on amputation

You may not know this The 5-year mortality after developing a foot ulcer is 42-44% (worse than many cancers) And after amputation 68-79% Only 2/3 of diabetic foot ulcers heal without surgery Up to 28% may result in amputation Person with diabetes has a 23-fold increased risk of lower limb amputation Many such amputations are avoidable Kerr M et al, Cost of diabetic foot disease to the NHS in England. Diabetic Medicine (accepted but unpublished)

Foot checks in primary care NDA data shows the proportion of diabetes patients receiving annual foot checks 85% across the TV is the same as national average For HbA1c it is 93% For BP it is 95% We’re missing a lot of feet!

And in secondary care

Today’s aims Reinvigorate a network approach to the management of diabetic foot care Learn more about the new National Diabetes Foot Care Audit ( NDFA); Understand why excellent foot care benefits everyone Share good practice and frustrations in equal measure Work with providers and CCG commissioners on the steps to achieving excellence