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The challenge:

Of the 270,000 people who live in South Tees, approximately 6,250 have diabetes. The South Tees area took part in an international study of lower extremity amputation rates, which covered centres in Europe, North America and East Asia. Of the four UK centres that took part, South Tees had the highest diabetes-related amputation rates. Additionally a local initiative called ‘Feet First’ identified that there were gaps in healthcare professional’s knowledge of foot care and foot health in people with diabetes.

Aims:

The aim of the project was to improve the foot health of people with diabetes in South Tees and to reduce amputation rates.

What did they do?

A multidisciplinary foot care team comprising diabetologists, diabetes specialist nurses (DSN), staff nurses, a senior registrar, a podiatrist and a general surgeon set about improving the foot care services for people with diabetes.

They developed new protocols and pathways for managing diabetic foot problems with input from with input from a vascular surgeon, orthopaedic surgeon, orthotist, podiatrist and diabetologist. The team addressed the shortfall in local HCPs knowledge by running educational events in the hospital. They also reached out to the general public through awareness events.

What changed?

Over a five year period lower extremity amputation rates fell by over 30 percent. The biggest improvement the team saw during this time was a fall in the number of people who were undergoing repeat major amputations caused by diabetes.