PUTTING
FEET
FIRST
September 2013
Overarching campaign objectives
• To raise awareness of the importance of people knowing their
risk status to empower them to take action to reduce risk of foot
problems and amputations
• To improve access of people with diabetes to quality foot
checks and appropriate referral by competent practitioners in
primary and secondary care
• To increase the proportion of localities delivering the integrated
footcare pathway, including provision of Foot Protection Teams
and Multidisciplinary Specialist Footcare Teams to provide a
structured programme of care
Integrated footcare pathway
Risk stratification tool
The first year: what we achieved
• Getting the footcare pathway used
throughout the UK − over 3,000 ordered
• Campaign Narrative downloaded 1,197 times
and 1,716 ordered
• Nearly 9,000 Top ten tips were ordered
• 22 PCTs/CCGs committed to reviewing their
footcare services
Parliamentary success in 2012 – 13
• Think tank and parliamentary reception Oct 12
• Lords debate – Nov 2012 – campaign mentioned
four times including by Earl Howe who said the
Government supported it
• Commons debate Jan 2013 – campaign
mentioned three times
• Times 26th January 2013 – Jeremy Hunt says
“we want to reduce levels of amputations by 50
per cent over the next five years”
2013:
TARGETING
HIGH RISK
GROUPS AND
POOR
OUTCOMES
2013 objectives and focus
• To raise awareness amongst those at high risk of foot ulcers
and amputations about what to look out for and how and where
to seek help
• To raise awareness of those caring for people with high risk feet
(including in community, hospitals and care homes) about what
to look out for and how/where to seek help/refer
• To increase the number of people with diabetes accessing
specialist multi-disciplinary footcare team within 24 hours of
presenting with an acute foot problem
• To increase the number of people with diabetes who have their
feet checked when in hospital
The audiences we are targeting:
• People with high risk feet and those who care for
them in various settings
• Commissioners and providers (CCGs and NHS
hospital trusts) with high numbers of
amputations
• Healthcare professionals (working in primary
and community services as well as hospitals)
• Government, parliamentarians and NHS key
decision makers (in all nations)
Multidisciplinary footcare teams
• There is evidence that rapid access to MDfTs
can lead to faster healing, fewer amputations
and improved survival
• But, 30% of hospitals don’t have such teams in
place (an improvement on previous years)
• Nearly half of diabetes specific admissions are
for foot disease (44%) but over half of these
(53%) are not seen by a multi-disciplinary team
within 24 hours
Targeting CCGs
Report of Policy Think Tank – Fast track for a
foot attack published February 2013
www.diabetes.org.uk
Recommendations for CCGs including:
• Root cause analysis for every amputation
• Supporting footcare networks
• Using footcare profiles to target
improved care
Targeting CCGs with high amputation rates
• Engagement with CCGs highlighting high
amputation rates and poor aspects of care in
local hospitals
• Media focus to highlight CCGs with high
amputation rates and any action being taken −
focus on 24 hour access to MDT and foot
checks in hospital
• Following up on commitments made by CCGs
with high amputation rates
What we have achieved so far in 2013
• Over half of the 50 CCGs with high amputation
rates have committed to action to reduce these
• NHS Trusts in high amputation rate areas have
told us about changes made since last year’s
audit which should show improvements in this
year’s performance
• The media coverage has again focused attention
on the issue in areas of high amputation rates
Next Steps: 2013
• Launch of red card for people at high risk of foot
ulcers and amputations and those with active
foot disease (expected Winter2013)
• Working with Vascular APPG on inquiry into
diabetes related amputations and PAD
• Following up on commitments made by CCGs in
high amputation rate areas (through Diabetes
Voices and Diabetes UK regional teams and
media)
Next Steps: 2014
• Exploring and highlighting impact of vascular
surgery reorganisation on MDTs and
amputations
• Focus on community support for medium and
high risk – Foot protection teams, podiatry and
peer support
• Focus on quality foot check in primary care
Working with healthcare professionals
• The Putting Feet First Campaign is supported by
healthcare professionals and is advised by a
group including the Society of Chiropodists and
Podiatrists, RCN and ABCD
• Diabetes UK are continuing to work closely with
partner organisations to make a real impact on
the devastating effects of amputation.