The challenge

Diabetic foot disease accounts for more hospital bed days than all other diabetes complications put together. In the UK, 100 people a week lose a lower limb because of diabetes. One in 20 people with diabetes will develop a foot ulcer in one year, and up to 70% of people die within five years of having an amputation as a result of diabetes.

What NHS Diabetes is doing?

NHS Diabetes is leading national and regional campaigns to reduce diabetic foot disease. The work includes:

• Launching national and regional footcare networks to bring together best practice, up-to-date guidance and tools. They also aim to reduce unacceptable variation of care and deliver better outcomes for people with diabetes.
• The NHS Diabetes Footcare Audit which involves scoping and defining the current and future requirements for a national diabetes footcare audit and underpinning dataset for inclusion in the National Diabetes Audit. 
• A commissioning guide (PDF 2MB) for footcare which includes an intervention map detailing all of the elements needed for the service as well as a contracting framework and service specification template. It supports our commissioning approach which offers a step-by-step guide in how to deliver high quality, efficient and cost effective diabetes services.
• Footcare guidance Putting feet first: national minimum skills framework (PDF 335KB), produced in collaboration with Diabetes UK. It responds to the need for nationally recognised minimum skills for the commissioning of diabetes footcare services. The framework provides a supportiveand robust quality assurance mechanism to enable those involved in service delivery to ensure that appropriately skilled healthcare professionals give care.
• A survey of the diabetes specialist podiatrist workforce in 2010 (PDF 44KB) - working in partnership with Diabetes UK we captured a unique picture of the diversity of roles, work settings, those working in isolation, and more.