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Download: Summary Success Story (PDF 177KB) / Full Success Story (PDF 136KB)
The challenge:
Over 6,500 adults in Poole have diabetes. About 5 percent of these people will develop a foot ulcer each year, and 10 to 20 percent of this group will go on to have an amputation. In 2007 the waiting time at Poole Hospital NHS Foundation Trust for new patients with potential foot problems was 2 to 3 weeks, and follow up appointments took 4 weeks. As a result patients were deteriorating and emergency admission rates were going up.
Aims:
Poole Hospital decided to change the way it delivered foot care services to people with diabetes. They wanted to reduce the number of hospital visits made by patients and reduce the risk of emergency hospital admissions.
What did they do?
A multi disciplinary team was set up. It was led by a diabetologist with responsibility for foot complications and included members of the hospital based podiatry service, a consultant podiatrist and community nurses. The team developed a business plan setting out the resources needed and the expected impact. The plan included proposals for additional staff members and additional capacity in clinics in both the hospital and community settings. Two new podiatrists were appointed to increase capacity in the hospital clinics, along with a consultant podiatrist to work across both hospital and community settings. In addition to implementing and evaluating the new service, the role of the consultant podiatrist was to develop referral protocols, care pathways and treatment algorithms.
What changed?
Capacity in the community foot care clinics has increased. New patients are still seen at the hospital, but many follow up appointments take place in community clinics. This has freed up capacity in the hospital footcare clinics and cut down the number of times patients attend hospital for an appointment. Now new patients are usually seen within 24 hours and follow up appointment waiting times are in line with clinical requirements.
Patient satisfaction was assessed by questionnaire and the results are shown in the table below.
| Criterion | Standard | Actual |
| Patient agreed with waiting time for an appointment | 100 percent | 95 percent |
| Patient agreed their appointment was on a convenient day | 100 percent | 100 percent |
| Patient agreed their appointment was at a convenient time | 100 percent | 100 percent |
Key Outcomes
- Majority of new patients seen within 24 hours.
- 100 percent of patients agreed their appointment was on a convenient date and time.
- 95 percent of patients were happy with the waiting time for their appointment.
- Potential savings of £60,000.
Appendices
- Appendix A - Referral Pathway (Word 36KB)
- Appendix B - Project Costs (Word 40KB)
- Appendix C - Business Proposal - Preventing Hospital Admissions (Word 75KB)
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.
