Diabetics not being assessed quickly enough for foot problems

Health leaders have been told that they are “a long way” from delivering national guidance for people in Shropshire with foot problems caused by diabetes.

An estimated 30,000 people across Shropshire have the insulin-related condition which can lead to foot ulcers, infections and in serious cases even amputation.

The NHS says it is important for people with diabetes to see a healthcare professional as soon as possible if they notice any problems with their feet.

A recent board meeting of The Shrewsbury & Telford Hospitals Trust was told that Shropshire, Telford and Wrekin is “an outlier for minor and major diabetes foot ulcers.

“We have a higher than national average of hospital spells for foot disease for people with diabetes (PWD).”

The board paper added that a recent audit has “shown we are a long way from delivering the National Institute for Health and Care Excellence (NICE) guidance.”

The board papers say that people with diabetes should have foot assessment within  six hours of admission to hospital.

But it adds: “Only 10 per cent of people with diabetes have a compulsory foot assessment within 24 hrs.”

It adds that only 42 per cent of people with diabetes should have a referral to a foot team member within 24 hours of finding a wound.

And only 13 per cent of people with a ‘high risk’ of developing a foot problem while in hospital were issued with heel offloading.

SaTH is taking a series of actions to assess people.

The board heard that a ‘majority of wards’ are now using a new assessment document, staff are being trained and ‘diabetes foot champions’ have been identied for every ward.

Board papers say they there is a clinical strategy priority for reducing hospital spells for diabetes foot.

But NHS leaders were told at a meeting earlier in May that there are challenges in the recruitment of key practitioner roles, a lack of health prevention and early interventions.

The problems have been a cause of increased length of acute inpatient stay, a lack of acute bed capacity, which has been “impacting on patient flow and reduced delivery of elective activity.”

Care for women with diabetes was also one of the issues picked up by the Ockenden review of maternity services.

SaTH has been told that it must develop a robust pregnancy diabetes service that can  accommodate timely reviews for women with pre-existing and gestational diabetes in pregnancy.

Dr Lorna Clarson, Chief Medical Officer for NHS Shropshire, Telford and Wrekin, said: “NHS Shropshire, Telford and Wrekin is collaborating with provider partners to ensure timely access to foot screening and appropriate foot care for our residents with diabetes both in and out of hospital.

“As part of our wider transformation of the diabetes care pathway, our Integrated Care System (ICS) is committed to delivering high-quality, consistent care closer to home for people living with or at risk of diabetes.”

A spokesperson for SaTH said that had nothing further to add.

Health watchdog Healthwatch compiled a report in 2023 which stated that there are currently 30,000 people living with diabetes in Shropshire, Telford and Wrekin (STW).

The Healthwatch report also said that the proportion of adults living with the condition is the 16th highest out of 42 areas in England.

They added that the rate of people receiving the ‘National Institute for Health and Care Excellence’ (NICE) recommended care processes is the lowest in the country.

Pic: Image by Jason Taix from Pixabay