Management of the high-risk foot
Podiatrists are experts at early diagnosis and management of the diabetic and neuropathic foot.
From 2015 to 2018 there were 27,465 lower limb amputations related to diabetes in England, an 18.3% increase of amputation linked to diabetic ulcers from the previous period. Podiatrists are highly skilled in the early detection and management of foot ulcers, playing a crucial role in the prevention of avoidable amputations.
Diagnosis of new problems
Podiatrists are experts in the diagnosis of conditions affecting the foot and ankle. Within primary care, the FCP podiatrist will apply their specialist knowledge of foot health across a broad range of clinical presentations spanning musculoskeletal, cardiovascular, neurological, dermatological, or age-related conditions. FCP podiatrists are trained to request and interpret a range of diagnostic tests, such as x-ray or blood tests, to help inform a diagnosis. Upon diagnosis, FCP podiatrists can provide personalised self-management advice, formulate treatment plans, or refer to other services.
- Early identification of problems to prevent chronic foot health issues and on referral to secondary care
- Management close to home
- Reduction in avoidable amputations
“8% of GP consultations for MSK are for foot and ankle pain. Enabling people who have foot pain to self-refer to a podiatrist working as a FCP … has the potential to significantly reduce the burden of foot and/or ankle pain on GPs, improve patient’s quality of life and prevent work-related absence.”
Support of people living with long-term conditions
FCP podiatrists have expertise in the support of people living with a range of long-term conditions. Some FCP podiatrists have additional expertise in focussed areas of clinical practice, such as diabetes, peripheral vascular disease, or musculoskeletal and rheumatic disease. FCP podiatrists are trained to request, interpret, and apply a range of disease monitoring tests, such as x-ray or blood tests, to help inform changes to treatment plans. FCP podiatrists can access and supply medications. With additional training, FCP podiatrists can also adjust or prescribe a wider range of medications including antibiotics.
- prevent or delay the onset of long-term conditions affecting the foot or ankle
- preserve foot and ankle health, reducing the risk of wounds, infection, or amputation
- preserve foot and ankle function, reducing the risk of immobility, or secondary consequences of reduced physical activity
- reduce foot and ankle pain and support people living with long-term pain
- reduce hospital admissions and secondary care referral
- lead medicine management for conditions primarily affecting the foot and ankle, saving GP time and resource.
20% of people aged 60+ in the UK are affected by Peripheral Arterial Disease, this is about 9% of the total population. Podiatrists specialise in the early detection and management of this condition preventing avoidable heart attacks, strokes, amputation and early death.
Maintaining physical activity and wellbeing
Poor foot health is a major barrier to mobility and social integration. FCP podiatrists support people to remain mobile, reducing the demand for home visiting services. Maintaining mobility also enables people to continue to access vital social activities such as work, family or carer responsibilities, or engagement in other religious or social networks integral to wellbeing.
- maintain and maximise mobility
- keep people physically active and able to work
- prevent or reduce the onset of long-term conditions through maintained mobility and physical activity
- reduce falls and falling risk
- enable independence leading to improved quality of life and reduced social exclusion
- support personalised approaches to care, including self-management, and reduce referral to community or secondary care services
Podiatrists have a significant role in the public health and prevention agenda specifically around falls prevention, cardio-vascular risk reduction, medicines management and reconciliation, antibiotic stewardship and keeping people mobile and active.