1. 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

2. 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

3. 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 Diabetic Medicine (accepted but unpublished)

4. 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!

5. And in secondary care

6. 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