Download: Summary Success Story (PDF 277KB) / Full Success Story (PDF 95KB)

The challenge:

There are approximately 34,000 people in Central Norfolk with diabetes. For several years the Trust successfully ran an integrated mobile retinal and foot screening programme. In 2006, funding for the mobile foot screening service for people with diabetes was cut, with general practice becoming responsible for foot screening. After the service was cut, however a survey of practices showed that there were large gaps in healthcare professionals’ (HCP) knowledge of foot health and screening.

Aims:

The project aimed to fill the gaps in HCP’s knowledge so they were able to carry out standardised foot screening assessment and implement referral pathways.

What did they do?

Led by the principal podiatrist from Norfolk and Norwich University Hospitals NHS Foundation Trust, and with input from Norfolk Community Health and Care, a business case and service specification were developed and presented to NHS Norfolk. The proposal was accepted and the team began to roll out a training programme for primary care nurses and healthcare assistants (HCA).

The training is given by a podiatrist from the specialist diabetic foot clinic and includes theoretical and practical sessions. By the end of the training HCPs have learnt about assessment, classifying risk status and making appropriate referrals. A month after the session participants undertake an exam to assess their competency, and are only deemed competent once they have passed this assessment. Seven training sessions took place in the first year of the project, and in the second year refresher courses were held, as well as two further initial training sessions.

What changed?

Before the training was rolled out 46 percent of HCPs (nurses and HCAs) had not received any formal training on foot screening. A total of 71 nurses, including 44 nurse practitioners/practice nurses, and 21 health care assistants have passed the competency assessment, this represents about 86 percent of GP practices.

In the year after this program was introduced Norfolk achieved 93.1 percent and 92.9 percent in both foot care screening Quality and Outcome Framework (QoF) targets.

The PCT now holds a register of those who have attended training and the training sessions are expected to continue and be expanded to community nursing staff.

Key outcomes

Appendices

• Appendix A - Business Case (PDF 73KB)
• Appendix B - Service Specification (PDF 137KB)
• Appendix C - Referral Pathway (PDF 47KB)

These appendices are supplied by the trust from which the success story originates. If you use content from the documents, please ensure you appropriately reference them in the normal style used by your publication/organisation.