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Download: Summary Success Story (PDF 275KB) / Full Success Story (PDF 117KB)
The challenge:
Faced with rising patient complaints and a number of clinical incident reports, the foot care service at Leeds Teaching Hospitals NHS Trust wanted to improve patient access to their service. The Trust serves a population of around 730,000 people, and about 27,000 of these are thought to have diabetes.
Aims:
The foot care service wanted to make it easier and faster for patients to get advice and treatment for diabetic foot problems.
What did they do?
The Foot Health Team set up a steering group and decided to run a seven week trial of a telephone hotline giving patients direct access to one of four podiatrists who would take turns to cover the hotline. The podiatrists had access to the on-call registrar. The steering group identified funding to pay for line rental and got agreement from the podiatrists and the on-call registrars. The phone line was available from 8am to 3pm, Monday to Friday and as well as being open to patients, carers and other healthcare professionals (HCPs) in both primary and secondary care could call with referrals. The hotline was publicised to patients and HCPs through intranet and internet sites, posters and leaflets in GP practices and through the community podiatry service. Patients referred through the hotline (self referred or referred by HCPs) were screened within 24 to 48 hours and urgent problems were referred directly to the on-call registrar.
Over the course of the seven week trial 45 calls were made to the hotline, and 73 percent of these were considered appropriate
What changed?
Of the appropriate calls:
- 39 percent were related to the presence of new ulcers
- 18 percent were related to the presence of deteriorating ulcers
- 42 percent were regarding red, hot, swollen or painful feet
- 70 percent (total number = 25) were seen as emergency cases within 24 hours and 6 percent within 48 hours.
Of the 25 patients seen as emergency cases treatment plans were as follows:
- 84 percent received debridement, cleaning and dressing of their ulcer
- 16 percent were admitted - no amputations occurred with this group
Key outcomes
- 70 percent of calls were considered urgent and seen within 24 hours.
- Four patients needed to be admitted, but none of these went on to have an amputation.
- The success of the pilot means there are plans to continue with the service and expand the hours it is available.
Appendices
- Appendix A - Diabetes Hot Foot Phone Report (PDF 449KB)
- Appendix B - LHP Diabetic Foot Infections Guideline (PDF 302KB)
- Appendix C - Care Pathway (PDF 37KB)
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.
